2005, 12-06 Permit App: 05004557 GarageProject Number: 05004557 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/06/2005 Page 1 of 2
Project Information:
Permit Use: 864 SQUARE FOOT DETACHED GARAGE
Setbacks: Front 6 Left: 5 Right: 61 Rear: 27
Site Information:
Plat Key:
Name: RANGE
Contact: MATTHEWS, KENNETH D
Address: 1019 N FOX RD
C - S - Z: SPOKANE VALLEY, WA 99206
Phone: (509) 217-4930
Group Name:
Project Name:
District: Nort
Parcel Number: 45161.1803
SiteAddress: 1019 N FOX RD
Location:: CSV
Zoning: UR -3.5
Water District:
Block:
Urban Residential 3.5
Area: 13,429 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot:
Owner: Name: MATTHEWS, KENNETH D
Address: 1019 N FOX RD
SPOKANE VALLEY, WA 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Site Plan Review
Released By:
Plan Review
Originally Released: 12/06/2005 By: cjjanssen
Released
N/A -ENGINEERED PLANS
Sewer Review
Permits:
Originally Released: 12/06/2005 By: cjjanssen
Released By:
Originally Released: 12/06/2005 By: cjjanssen
Operator: CJJ Printed By: CJJ Print Date: 12/06/2005
Project Number: 05004557 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/06/2005 Page 2 of 2
Contractor: OWNER
Building Permit
Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VB 864 $16,416.00 864 $16,416.00
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
Notes:
Payment Summary:
Permit Type
Building Permit
Totals: 864 $16,416.00 864 $16,416.00
Units Unit Desc
1 SELECT
1 SELECT
Permit Total Fees:
Fee Amount
$279.25
$4.50
$283.75
Fee Amount Invoice Amount Amount Paid Amount Owing
$283.75 $283.75
$0.00 $283.75
$283.75 $283.75 $0.00 $283.75
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: CJJ Printed By: CJJ Print Date: 12/06/2005
Permit Center
SpokaneogessOlN11707 E Sprague Ave, Silit�1106
....,OValley Spokane Valley, WA 99404 � ,
(509)688-0036 FAX: (509)688-0037 +
Community Development www.spokanevalley.org. _ \`
,t
01 ll\.
Residential Construction ❑ New Construction (,A(cessory Bldg
Addition/Remodel ❑ Deck
o Other:
PERMIT NUMBER/
PERMIT FEE:
Permit Application
SITE ADDRESS /C9
ASSESSORS PARCEL NO: U '/ /' / "t' LEGAL DESCRIPTION:
Building owner
Name: K P > � 1116. +- )71 e_ ut)_
Address: 1' P) -
City: Q ay(P Oa J IPy Zip: L/
Phone:'C9v?1?-`-{�J7C'Fax: yc2,2-0 jL%0
Contact Person
� Y'l�f�s
Name:
Phone: 5 r ) 7—/ 9 `3 d
Describe the scope of work in detail:
Contractor.
DIMENSION1S;,
# OF STORIES:
Name:
MAIN FLOOR 71 SQ.
FTG: q /
rC
2ND FLOORSQ. FTG:
` `
C
Address:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
City:
DECK/COV. PATIO SQ. FTG:
Zip:
Phone:
�NS RT�� TYPE:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
•
Cost of Project:
$ x000 ,
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TQ PEAK:
DIMENSION1S;,
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR 71 SQ.
FTG: q /
rC
2ND FLOORSQ. FTG:
` `
C
UNFIN BASEMENT SQ. FTG:
j
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
SRA S 2. G:
�j
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
�NS RT�� TYPE:
HEAT SOURCE:
SEWED R SEPTIC?
DISCLAIMER
The permitee verifies, acknowledges and agrees by their ignature that 1) If this permit is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Own rs ip of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances. 6) Plans ori&ttional information may be required to be submitted, and subsequently approved before
this application cbe proceys
Signature /
�� ///, / �����_-_------... - Date
Method of Payment: (Faxed pfirmit applications will only be accepted with major bankcard)
0 Cash )Check 0 Mastercard 0 VISA 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/252005
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