2003, 01-13 Permit App: 03000235 Residencet •
Project Number: 03000235 Inv I Application Date: 1/13/2003 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
_.
Permit Use: RESIDENCE W/GARAGE - GAS
Contact: CONSTRUCTION INS SRVCS INC
Address: 8907 E MAIN
C - S - Z: SPOKANE WA 99212
Setbacks: Front 26 Left: 16 Right: 10 Rear:
Phone: (509) 891-2880
Group Name:
Site Information:Project
Name:
Plat Key: Name. ry ��
.. District: F
Parcel Number: 45251.1608 Block:
Lot: 8
SiteAddress: 17001 E DAYBREAK LN Owner: Name: CREEKSIDE CONSTRUCTION
VERADALE, WA USA 99037
Address: 8907 E MAIN
Location:: VER
SPOKANE WA 99212
Zoning: UR -7 Urban Residential -7
Water District: 010 VERA
Hold: ❑
Area: 17,082 Sq Ft Width: 100
Depth: 173 Right Of Way (ft): 35
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Revi
Site
Plan Review Released By: a .
Approach / Drainage L Released B_v:�___ _
Sc��cr Review�Relc B t,%' ZAo ► �'�
Permits:
Operator: JAS Printed By: JAS Print Date: 1/13/2003
Project Number: 03000235 Inv: I Application ' Date: 1/13/2003 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: CONSTRUCTION INS SRVCS LLC
Address: 8907 E MAIN
SPOKANE WA 99212
Building Permit
Firm: CONSTRUCTION INS SRVCS LLC
Phone: (509) 891-2880
Building Characteristics
Const Category: New Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: ❑
Description
2ND FLOOR
BASEMENT U
GARAGE
RESIDENCE
Grp
Type Note
R-3
VN
R-3
VN
U-1
VN
R-3
VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes
This Application:
1,120
Sg Ft Valuation
1,120
1,120 $73,920.00
748
1,120 $13,776.00
1,120
748 $8,976.00
LLC
1,120 $73,920.00
Totals:
4,108 $170,592.00
Units
Unit Desc
1
Y OR BLANK
1
Y OR BLANK
1
Y OR BLANK
Total
Sq Ft
Project:
Valuation
1,120
$73,920.00
1,120
$13,776.00
748
$8,976.00
1,120
$73,920.00
4,108 $170,592.00
Fee Amount
$1,250.00
$4.50
$275.00
Permit Total Fees: 1$101.00
Operator: JAS Printed By: JAS Print Date: 1/13/2003
Permit Total Fees:
$1,529.50
Mechanical Permit
Contractor: CONSTRUCTION INS SRVCS
LLC
Firm: CONSTRUCTION INS SRVCS LLC
Address: 8907 E MAIN
Phone:
(509) 891-2880
SPOKANE WA 99212
Item Description
Units
Unit Desc
Fee Amount
GAS WATER HEATER
1
NUMBER OF
$10.00
GAS APPLIANCE >100,000BTU
1
NUMBER OF
$15.00
GAS PIPING
4
# OF UNITS
$4.00
HEAT PUMP OR A/C 0-3 TONS
1
NUMBER OF
$12.00
VENTILATING FANS
3
NUMBER OF
$30.00
CLOTHES DRYER
1
NUMBER OF
$10.00
GAS LOG OR GAS INSERT
1
NUMBER OF
$10.00
HOOD -TYPE II
1
NUMBER OF
$10.00
Permit Total Fees: 1$101.00
Operator: JAS Printed By: JAS Print Date: 1/13/2003
i
Project Number: 03000235 Inv: 1 Application Date: 1/13/2003
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: CONSTRUCTION INS SRVCS LLC Firm: CONSTRUCTION INS SRVCS LLC
Address: 8907 E MAIN Phone: (509) 891-2880
SPOKANE WA 99212
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER USING DEVICES
Notes:
Pavment Summa
Units
Unit Desc
Fee Amount
3
NUMBER OF
$18.00
6
NUMBER OF
$36.00
1
NUMBER OF
$6.00
2
NUMBER OF
$12.00
1
NUMBER OF
$6.00
1
NUMBER OF
$6.00
1
NUMBER OF
$6.00
4
NUMBER OF
$24.00
Permit Total Fees: $114.00
Page 3 of 3
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,529.51 $1,529.51 $0.00 $1,529.51
Mechanical Permit $101.00 $101.00 $0.00 $101.00
Plumbing Permit $114.00 $114.00 $0.00 $114.00
$1,744.51 $1,744.51 $0.00 $1,744.51
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: JAS Printed By: JAS Print Date: 1/13/2003
1 ! PROJECT APPLICATION WORK SHEET
SPOK.-1NE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
"NOM19 SPOKANE, WA 99260
r, 509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
Assessors Tax Parcel Numher(s):
Legal Description:
/-.o 7 -
Project
Project Description:
It Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other
Department Use Only
Water District/Purveyor:
Sewer District/ purveyor
Road width
Setbacks
Front Re r
l.ek: It,�•hc
School Distract:
Tire District
Zoning
OWNER/APPLICANT INFORMATION
❑ Owner:
Phone: � �w' !�
❑ Applicant Phone: 11'? [— 2ar"�,Cv, ,
G SrDC
�.e�? Fa.: - (-C�i20
4Ny7.cvu�o,✓ I.NSrJ.�-A.�'� sec�a��t
Mailing Address:
Unfinished basement sq. ft.
Mailing Address:
AY07 e
�5907
Cin, Stare, Zip
Occupancy group
(:in', State, Zip
,l~N
aZ
Sod [ce eu14 `l'tj l�
Contractor
Phone
❑ Phone In hnccL'Iinlnnecr
v
rj J�Sc>i�'�e. a.
] Is
Mailing address
Mailing address
,670,7e 114
)
Al
City, State Zip
City, State Zip
'06 lccz)e-
�vfl
\\ A State Contractor license
#
Contact name:
T
A}
PR(nF('T 1N1PnPX,4A'V1"XT
Building Information
Building height to peak
# of stories
Main Floor sq. ft.
Unfinished basement sq. ft.
Dimensions
,y 42,9
Total habitable space
0
2°1] floor sq. ft.
/ rev
Finished basement sq. ft.
Occupancy group
Construction type
,S TlGI� arc r4r.G�
Garage sq. ft.
Deck sq. ft
Cost of project
1 feat source (electric, gas, etc.)
Manufactured Home
Sign—�
Width:
Length:
What is the square footage of the sign
fitce?
I low high is the sigm?
Year:
Make
# of signs
Area of existing signs
O Don't know O Yes Ar -No
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
Relocation
Fire Safety
Previous address
Fire Sprinkler
Paint booth Fire Alarm Fireworks display
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Finn Name Phone
Plans Fyaminer Phunc
Inspectors:
Address
I es, identify on site plan O Yes S3-570
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes o
What is the current property sire?
1 yes, identifi on site plan
(square feet or acres) 1 7 3 v v
Is any part of the property within 250 feet of a shoreline?
What is the current use of this property?
I es, identify on site plan O Yes S3-570
O No
Is your property in a designated wildlife habitat area?
Will the site be sensed by a septic system? O Yes thio
O Don't know O Yes Ar -No
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
I Eyes, idem,# on site plan
Ifyes, identify on the site plan O Yes lom
O Ala be O Don't know O Yes No
O Yes O No
Are there any wetlands, streams or ponds within 200 feet of the property?
Is there evidence of fill or excavation on the property?
1 es, i lift on site lan O Yeso
O Yes o
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
Are critical or hazardous materials used or stored on site?
O Yes WNo
O Yes v1Q—'No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
Is public sewer available to the site? O Yes O No
O Yes
O No
Is the property inside the ASA? Q Yes
O No
Is public water available to the site? 0 Yes O No
O Yes
O No
Is the property inside the PSSA? 0 Yes
0 No
Is the property located within 1000 feet of a Natural Resource Area?
O Yes O No
Date Received: SMff Rcpresentat",
METHOD OF PAYMENT
❑ CASII ❑ CHECK ❑ � ❑ ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNA'T'URE:
EXPIRES:
SUBTOTAL
TOTAL FEE
alI,VIMVM PERMIT FEE IS S35.00PI.EASE
`d \ Kh CHECKS PAY.A111.E TO SPOKANE
COUNTY PER.IIIT CENTER
,ZONE � � . 3`� •,^}K1 a
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