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2002, 03-20 Permit App: 02001754 Pole BldgProject Number. 02001754 Inv: /• t- Application TI -IIS IS NOT A PERMIT Dale: 3/211/211112 Page 1 of 2 Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 30 X 411 POLE BUILDING Contact: EXCALIBUR STEEL STRUCTURES INC Address PO BOX 14991 C - S - Z: SPOKANE, WA 99214-0991 Setbacks: Front 511+ Left: 9 Right' 51 Rear: 9 Phone (509) 994-8985 Group Name: .Site Information: Project Name: Plat Key. 001984 Name. PEPLINSKIS IST ADDITION District: H Parcel Number. 451111.114114 Block: Lot: SiteAddress: 4621 N LARCH RD Owner: Name: BLYTIIE, DAVE SPOKANE, WA 99206 Address: 4621 N LARCH RD Location: SPO Zoning: UR -3.5 Water Dhstnct Urban Residential 3.5 SPOKANE, WA 99216 Hold ❑ Arca: II Sq Ft Width 11 Depth: 11 Right Of Way (CD. 11 Nbr of Bldgs' 1 Nbr of DIwllmgs 1 Review Information: Review Site Plan Review Released By Plan Review 1 Released B1`:: .. S E'K%(Oi1t. ` ,� worm&ete Permits: Operator: RMB Printed By RMB Print Date: 3/20/2002 Project Number. 02001754 Inv 1 Application-• Date: 3/20/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: EXCALIBUR STEEL Firm: EXCALIBUR STEEL STRUCTURE Address: PO BOX 14991 Phone (509)'921-1300 SPOKANE, WA 99214-0991 Building Characteristics Const Category: New Group. U-1 Type VN Nbr Of Dwellings 1 Occupant Load 0 Building Height' 19 Stories 1 Bldg W x D 30 s 40 Building Sq Ft:121111 Sprinklers: Req Parking 0 Handicap Parking: 0 Critical Matenals- ❑ This Application: Total Project: Description Grp Tvpe Notes Sy Ft Valuation Sy Ft Valuation GARAGE U-1 VN 1,2110 $14,401100 1,200 $14,400 00 Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Notes: Payment Summary: Permit Type Building Permit Totals: 1,200 $14,400 00 1,200 $14,4011.00 Units Unit Desc Fee Amount 1 Y OR BLANK $225.50 1 Y OR BLANK $4 50 1 YORBLANK $49.61 Permit Total Fees: $279 61 Fee Amount Invoice Amount $279.61 $279.61 Amount Paid $U 00 Amount Owing $279.61 $279.61 $279.61 $0.011 $279.61 Disclaimer: - Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained ssithin to he 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 contrued 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. RMB Printed By RMB Print Date: 3/20/2002 10011 PROJE .,j PPLICATION WORK SHEET SPOKANE COUNli B VI' 0 OF BUILDING & CODE ENFORCEMENT itt 'OAD\VAYAVENUE P • IC A N E POK{MRE •'SUNPY BUILDING AND ODE ENFORCEMENT 77-Q5 O 1_J N T Y A DIVISION OF THE PUBLIC WORKS DEPARTMENT James L. Manson, C.B.O., Director SPECIFIC SITE INFORMATION Gary Oberg, Director 14(:/al ' ` ` LTV OCff Assessor's Tax Parcel Number(s): Street Address: Legal Description: Project Description: :«; Building Permit ❑ Change m Use ❑ Grading ❑ Manufactured 1-lome Permit ❑ Relocation ❑ Sign O Tenant(New/Change) O Other Department Use Only - .. \Carer Dotnct/Puneyoe Scutt Distncr/Punc%or Road•,Jth _ Setbacks. Front Rear. _ Left Right: School District. F rc Ihstriet ' 'Lonmg OWNER/APPLICANT INFORMATION 1rrAvlr who Jrudrl be mrrlederl meurrtme Ihirhmrew 0 CCneneePh'me Clic - 2489 Gl[(��v I c& 1..)` �tTr_ o . I as Budding heght to peak I / 0 Applicant. et Phone Fas Nailing Addis.,1 %a1 fi. Led_ rcL 'Total habitable space hlultng Address hushed basement sq f t Occupancy group -14--op COQ, Stine, Zip SCPok WA ggz1lA Garage sy ft City, State, Zip C. I leaf source (electric, gas, ate) p�r t Contractor(�� cI Phone VIZI - t 300 Excalibur JiC,Ets5 'wc}ute5 Fax Fax C) Z 1 - 4718 ❑ Architect/Engineer - Phone Fax Alining address P.o. B.t 1(49ci1 M.admg address Croy, State Zip SPalc.,2 ,—Q. l,JA RZ1t-1 City, State Zip \\'A Stair (Contractor licenser# EXCALS5 DOOCS I / Contact name PROTECT INFORMATION Building Information Budding heght to peak I / # of stones Main floin sq ft Unfinished basement s4 ft. Dimensions 3oxLIo x IL4 'Total habitable space 2a`I floor sq. ft. hushed basement sq f t Occupancy group -14--op Construction type Pale QvI•;tom Garage sy ft Deck sq ft Cost of project I leaf source (electric, gas, ate) 1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050 ('HONE: (509) 477-3675 • FAX: (509) 477-4703 • TDD: (509) 477-7133 Manufactured Home Sign Width 1.englh. What is tha;square footage of the sign face? I low high is the sign? Vane Make: # of signs Area of existing signs Are or will there be wells located on the property? Ifyes, identify on the site plan - 0 Yes No • Proposed use Value Address Relocation - - Fire Safety Previous address What is the current use of this property? C e 5 i a_ tiv`c e_ Fire Spnnklcr Tent Paint booth Fire Alarm Fireworks display _ Are or will there be wells located on the property? Ifyes, identify on the site plan - 0 Yes No • Proposed use Value Address No Special Inspections Required? ' Non -Residential Energy Code Compliance? A Firm Name What is the current use of this property? C e 5 i a_ tiv`c e_ Phone Plans Examiner Phone • 0 Yes ,- 0 No Inspectors. Are or will there be wells located on the property? Ifyes, identify on the site plan - 0 Yes No • Are there any wetlands, streams or ponds within 200 feet of the property? If yes, rdentrfy on site plan 0 Yes No Address No ' Are critical or hazardous materials used or stored on site? O Yes --;:o Inspector Phone ❑ Concrete O Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? Pi.,Yes 0 No If yes, identify 0n site plan \X That is the current property size? (square feet or acres) f?^. 1 `i •` 0: Yess:;0'No . . •- . Is any part of the property within 250 feet of a shoreline?p./ If yes. identify an sae plan 0 Yes F'l No What is the current use of this property? C e 5 i a_ tiv`c e_ Is public water available to the site? ' Is your property in a designated wildlife habitat area? 0 Don't know 0 Yes %No Will the site be served by a septic system? 0 Yes p5C.No 1 - ' • 0 Yes ,- 0 No Is any part of the property within a 100 yr flood plain? Eyes, zdenttfy an site plan 0 Maybe 0 Don't know 0 Yes liie....No Are or will there be wells located on the property? Ifyes, identify on the site plan - 0 Yes No • Are there any wetlands, streams or ponds within 200 feet of the property? If yes, rdentrfy on site plan 0 Yes No Is there evidence of fill or excavation on the property? - 0 Yes No Are there slopes greater than 30% on the property? (3f nse in 100 ft) ( /^o) 0 Yes WNo Are critical or hazardous materials used or stored on site? O Yes --;:o •a DEPARTMENT USE ONLY Is'the pioperty'iri a designated Stormwater Control Area?: - "" ,-ii -.` '-;'. . ':°. 0 -Yes O•No -Is public sewe.r'available io the;site? '• •. A f?^. 1 `i •` 0: Yess:;0'No . . •- . ':Is'the pioperiy inside: the ASA?,, •. :' 0 :Yes , 'O -No Is public water available to the site? ' : +', ,' ;j• O Yes," O,t No 3s the property inside the PSSA? : - '. - • 0 Yes ,- 0 No •Is the property Joeated within 1000 feet of a NaturaliResource A ea?i) Date Received Staff Representative: METHOD OF PAYMENT VISA ❑ CASA ❑ Cl IECK 0 DUCOVER FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATIS: EXPIRES: BANI:CARD NUMBER: AUTI IORIZED SIGNA I'URE. SUBTOTAL .TOTAL FEE MINIMUM PERMIT FEE ISSt5OXPI EASE - MAKE CIIECKS PAYABLE TO SPOKANE COUNTY PER I1 CENTER , • 4 ,b PRoPoSED SN 0? ►� x 0 %Y NS Tr, A ADDRESS� `1b1 LA ZONE Lt a•S ROAD WIDTH CO FRONT 50 FLANKING GOMMEP' EVIEWED This site plan is being submit cd for the purpose of obtaining a builaing permit ar d is a true and correct representation of the propos. All known property Tines/dimensions, curb lines, structures and easements have been 'dental Also ince icated are wetlands, bodies of water, st slo?ekor 'Teal areas. Signed: Date 3 • Z O • 6 - Oh hD Vi