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192005, 02-18 Permit App: 05000525 Pole BldgProject Number: 05000525 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 02/18/2005 Page 1 of 2 Project Information: _, Mri. Maw Permit Use: 24 X 36 POLE BUILDING Setbacks: Front 115 Left: 15 Right: 71 Rear: 15 Site Information: Plat Key: Name: PINKERTON PARK ADD Contact: COLLICOTT, MAUREEN 15 N GREENACRES RD GREENACRES, WA 99016-7720 (509) 939-3170 Address: C - S - Z: Phone: Group Name: Project Name: MatinetngaRMAMM- aNSFALEMEMESMESIONSIMM District: East Parcel Number: 55184.3303 Block: SiteAddress: 15 N GREENACRES RD Location:: GRE Zoning: B-2 Water District: Area: 30,475 Sq Ft Community Business Width: 0 Lot: Owner: Name: COLLICOTT, MAUREEN Address: 15 N GREENACRES RD GREENACRES, WA 99016-7720 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information Review Site Plan Review Plan Review Septic System Review Permits: Released By: Fi4(20,c6A- Icfqr— Operator: K_C Printed By: K_C Print Date: 02/18/2005 Project Number: 05000525 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 02/18/2005 Page 2 of 2 Contractor: OWNER Group: U-1 Type: VB Total Area 864 Building Height 16 Stories 1 Building Permit Firm: OWNER Phone: (000) 000-0000 Building Characteristics 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 Totals: 864 $16,416.00 864 $16,416.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $279.25 ACCESSORY PLAN REVIEW 1 SELECT $69.81 STATE SURCHARGE 1 SELECT $4.50 Permit Total Fees: $353.56 Payment Summary: EMZEMEME.- -.WEVIVESOIWZRWORMEMMSMSEVXMAIMEIMMIRMITMOSMEaft Permit Type Building Permit Fee Amount Invoice Amount $353.56 $353.56 Amount Paid $0.00 Amount Owing $353.56 $353.56 $353.56 $0.00 $353.56 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: K_C Printed By: K_C Print Date: 02/18/2005 *Ohne BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: ,4i, ) S 6 feemaccesA 12J Assessor's Tax Parcel Number(s): 55/ ' L/, 3 O 3 Legal Description: 2__n_ n ke(+o{\ "PK T( LL 3 ' N I's- cf 4 Sy/ t�5 PERMIT DESCRIPTION: —Pa) to ik Building Permit H Relocation p Change in Use ❑ Grading E Manufactured Home n Tenant Improvement ❑ Fire Safety n Other OWNER/APPLICANT INFORMATION n Owner: 6e,k_u{'Q,2,(\ U\,GiA* 6f4 171 Phone3ag939 -31 0 Fax: So9 9z t-oy Z� Address: /�.l S cks., Contractor: State Zip Code Se_l u.A.Qcs) Q( Phone: Say .F3?„3/76 Fax: Address: City State WA State Contractor License #: Zip Code n Applicant: KpIrip A -g Phone: socr.crW- iCZSZ Fax:3 9.9 Address:).15L�I�Qnac.lt� o _� A) C1 State Architect: Phone: 940 Zip Code Address: Fax: City Contact: State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: 1. DIMENSIONS: , Zy x at." # OF STORIES: , MAIN FLOOR TO SQ. FTG: % cg 2' FLOOR SQ. FTG: Iv/� UNFIN BASEMENT SQ. FTG: N/A - FINISHED BASEMENT SQ. FTG: N/A GARAGE SQ. FTG: . NAH CONSTRUCTION TYPE: mole DECK/COV. PATIO SQ. FTG: NM HEAT SOURCE. rV/a OCCUPANQY GROUP: . # OF BEDRO/OM: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: ti `,�nP�2�,°� 30% SLOPES ON PROPERTY: — SEWER OR ON-SITE SEPTIC SYSTEM? ..;04-;c____. L MANUFACTURED HOME Width: Length: Year: Manufacturer: Pit Set: RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Phone: Fax: City Inspector: Phone: Fax: Address: State Zip City State Zip SPECIAL INSPECTIONS BOLTING ❑ CONCRETE Firm Name: E REINFORCEMENT Phone: I nspector(s): Fax: n WELDING DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership 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. Ownership of resulting development rights granted by any issued permit inure the property owner Print Name l4Lae,eft ebil; Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) f Cash ❑ Check Bankcard #: Authorized Signature: ❑ Mastercard ❑ VISA ❑ Other Expires: VIN#: //GUUD ID.J0 JUZOL4IJOI FEB le 2005 15:04 FR J,11.1.1 Project Number: 0000525 Inv: 1 Application THIS IS NOT ATER:MIT Penalties will be assessed for commencing work without a permit Rroitalsfermation: ........am.E.......emovemegags.w....mmisiosamemac OS SIMIRVIEMPION Permit Use: 24 X 36 POLE BUILDING Contact: COLLICOTT, MAUREEN Address: 15 N GREENACRES RD C - -Z: GREENACRES, WA 99016-T70 Setbacks: Front 115 Left: 15 Right. 71 Reer: 15 Phone: (509) 939-3170 Group /am: Project Name: TO 3241567 Date: 02/18/2005 Page 1 of 2 Site Informatiorgs. acmaimm, VIICIEMPUMMEMOMMINIIii Plat Key: Name: PINKERTON PARK ADD Parcel Number. 55184.3303 Block: SiteAddress: 15 N GREENACRES RD Owner Name: 'COLLICOTT, MAUREEN Address: 15 N GREENACRES RD Location:: GRE 'GREENACRES, WA 99016-7720 Lot: armuwouwwwww District: Ease • • • Zoning: B-2 Water District: Community Business gold: 0 Are; 30,475 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of)31dgs: 2 Nbr of'Dwellings: 1 ReviewmommeargsfaMblegltrellOMMIIM Review Site Plan Review Plan Review mesasuanittlailMIIIICAVII ZWAIINCemarce Septic System Review eszpsits: =mom, Operator K_C: Printed 13y: KC FEB 18 2005 16:02 Print Date: 02/18/2005 509324156? PAGE.01 IViaf4k -or IIS ) PLANNING DEPT. APPROVED BY: 1717/ DATE: 4', y 3 G 4 4; Propos cr‘syvte - Acoy\54. Otktaist ZONE ROAD WIDTH COMMENTSFRONT-Lb....± FLANKING REVIEWED SY •tf ' This alto plan is being subnitned ler Ole purpose ot Obtaining a buildngprom* and is s Wu* sold correct representation cv the propoSe. lancleat property linesIdimensioni , curb lineS. StPUOIllarrmailld easements have been ideptified, wellestee are wetlands, bodies ot Wale , stee if 1 areas. Signed: Date: L4 5- GKEenkute 4r C v LLto