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2005, 04-13 Permit App: 05001177 Pole BldgProject Number: 05001177 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 04/13/2005 Page 1 of 2 Project Information: Permit Use: 24 X 36 POLE BUILDING Contact: EXCALIBUR STEEL STRUCTURES INC Address: PO BOX 14991 C - S - Z: SPOKANE, WA 99214-0991 Setbacks: Front N/A Left: EX Right: 5 Rear: 5 Phone: (509) 921-1300 Group Name: Site Information: Project Name: Plat Key: 001984 Name: PEPLINSKIS OIST ADD District: East Parcel Number: 45011.0409 Block: SiteAddress: 4507 N LARCH RD - Location:: CSV Zoning: SFR Water District: Lot: Owner: Name: RIFE, ROGER Address: 4507 N LARCH RD SPOKANE VALLEY, WA 99216 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Released By: Permits • Operator: K_C Printed By: K_C Print Date: 04/13/2005 Project Number: 05001177 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 04/13/2005 Page 2 of 2 Building Permit Contractor: EXCALIBUR STEEL Firm: EXCALIBUR STEEL STRUCTURE Address: PO BOX 14991 Phone: (509) 921-1300 SPOKANE, WA 99214-0991 Building Characteristics Group: U-1 Type: VB Total Area 864 Building Height 14 Stories 1 This Application: Total Project: Description Grp Type Notes Sci Ft Valuation Sci Ft Valuation GARAGE U -I VB 864 $16,416.00 864 $16,416.00 Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE Notes • Totals: 864 $16,416.00 864 $16,416.00 Units Unit Desc 1 SELECT I SELECT Permit Total Fees: Fee Amount $279.25 $4.50 $283.75 Payment Summary: Permit Type Building Permit Fee Amount Invoice Amount Amount Paid Amount Owing $283.75 $283.75 $0.00 $283.75 $283.75 $283.75 $0.00 $283.75 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: K_C Printed By: K_C Print Date: 04/13/2005 Spokane 40,Ua11ey BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: q5-07 /J . Assessor's Tax Parcel Number(s): Legal Description: n PERMIT DESCRIPTION: PO IQ Q w, 1 dC+ m .•1 Building Permit ❑ Relocation ❑ Change in Use ❑ Grading ❑ Tenant Improvement 0 Fire Safety 0 Other ❑ Manufactured Home OWNER/APPLICANT INFORMATION Owner: O(ar R Phone: /`R- 5$`/ Fax: Address: 4'5-6-7 A). La -4 -c -/-- a ka-44..#2 LG..rcL. akce WA 9%21(0 Ci State Zip Code Applicant: Phone: Address: City State Zip Code V Contractor: Ex&Sbar 4e(S e< . • 0 Architect: Phone: 1Z/ -130o Fax: qv -6.1/8^ Phone: Fax: Address: Po, Box /v/1/ Address: Spokes -4..-e W A 51 1Z-01 City State Zip Code City WA State Contractor License #: E*34LSS cones Contact: State Zip Code Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: iii t DIMENSIONS: ayx3� X (U # OF STORIES: I MAIN FLOOR TO SQ. FTG: tee(' Ir 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: S OTR U CONSCTIIO��� HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? ADS" ;;Tdi%waFti,1/4NIUNG FRONT coMMENnIS: REVIEW,E' Na plan is beiny submitted for the purpose of 4 bullceno permit and is a true and cloned, of !the proposal Ail kw., imiporty tell 1110S S l r1 .•••4111111118 I Also " .•.. p s us O lan culled areal'. --i • • geksg-.: .84.04<