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2005, 08-18 Permit App: 05002922 AdditionProject Number: 05002922 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/18/2005 Page 1 of 2 Project Information: Permit Use: ADDITION TO RESIDENCE Setbacks: Front Site Information: Plat Key: Left: Right: Rear: Name: ORCHARD ACRE TRACTS Contact: JOHNSON, KIRK A Address: 3319 N LILY RD C - S - Z: SPOKANE VALLEY, WA 99212 Phone: (509) 863-2418 Group Name: Project Name: District: Nort Parcel Number: 35014.0147 SiteAddress: 3319 N LILY RD Location:: CSV Zoning: UR -3.5 Water District: Block: Urban Residential 3.5 Area: 14,800 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Lot: Owner: Name: JOHNSON, KIRK A Address: 3319 N LILY RD SPOKANE VALLEY, WA 99212 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Site Plan Review Released By: GIVEN TO PLANNING 8/15/05 Plan Review Permits: Originally Released: 08/15/2005 By: KKENDAL Released By: Originally Released: 08/10/2005 By: TMELBOU Operator: CJJ Printed By: CJJ Print Date: 08/18/2005 Project Number: 05002922 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/18/2005 Page 2 of 2 Building Permit Contractor: OWNER Firm: OWNER Phone: (000) 000-0000 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation RES ADD R-3 VB 600 $44,808.00 600 $44,808.00 Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW Notes: Payment Summary: Permit Type Building Permit Totals: 600 $44,808.00 600 $44,808.00 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Permit Total Fees: Fee Amount $593.25 $4.50 $237.30 $835.05 Fee Amount Invoice Amount Amount Paid Amount Owing $835.05 $835.05 $0.00 $835.05 $835.05 $835.05 $0.00 $835.05 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: 08/18/2005 /21 GL BUILDING PERMIT APPLICATION WORKSHEET Scff S .0 City of Spokane- Valley Community Development Department „) 4 Building Division Vi11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 PhDfl : (509) 688-0036; Fax: (509) 688-0037 Dalley \n'' REG..I b BITE INFORMATION Street Address: 33 / /4_,/yi 5 d (le,81 Assessor's Tax Parcel Number(s): Legal Description: � PERMIT DESCRIPTION: /f �� Building Permit ❑ Change in Use ❑ Grading n Manufactured Home O Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other I OWNER/APPLICANT INFORMATION O Owner. if ,ti /w17) 0 Applicant: /yip / t iRS6v/ Phone: gic7 --cgtFax: Phone: Fax: Address: if -?3/y Gly Address: Ce, I lel t)j /�- ity State Zip Code City State Zip Code ❑ Contractor: 0 Architect: Phone: Fax: Phone: Fax: Address: Address: City State Zip Code City State Zip Code • WA State Contractor License #: Contact: Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION k• d HEIG TO PEAK: / p `- Lf DIMENSIONS: •D -v / > 20 / # OF STORIES: / MAIN FLOOR TO SQ. FTG: ',Az: 60Dalct 4e.,,i /l Yf /oh( 2741j FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: / rr cut/ TOTAL HABITABLE SPACE: IMP RVI US SURFACE AREA: PST OF PROCT: a. 000 °.-- 30% SLOPES ON PROPERTY: "ion e SEWER OR ON-SITE SEPTIC ` , SYSTEM?3c7f/e 4O't) At --/S /v1 Stir e 1100/( UU/iI/LWO 1L.JL JG7JL:il JOI r"'t i✓ 1-11,J -- OS TO 324156? P.02/0? - ��1.-4t 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 SPane 40,Valle Street Address: f5� REQVIRED SIdillIFORMATION Xrotyt,Seo ���`,�c,✓,� Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: Bulld[ng Permit Relocation 1 ❑ Change In Use 0 Grad' al Tenant Improvement 0 Fire Sa ATIrSeer ty ❑ Manufactured H, me Other OWNER/APPLICANT INFORMATION 0 Owner. /6d /1.6/1/75o4 Phone: 5aF-7'3-� (thrFax: Address: /1 33/1 Cii Y State Zip Code 0 Applicant: Phone: Address: ❑ Contractor. 0 Phone: Address: Fax: aty Clty Architect: Phone: Fax: Address: State Zip Code Slate Lp Code Gty Stag • WA State Contractor License #: Contact: Spokane Valley Bus. Liscense #: Contact: Zip Code HEIO i a vis F TO PEAK FLOOR TO SQ. FTG: PERMIT/BUILDING INFORMATION 2 FINISHED BASEMENT SQ. FTG: OCC PANCY GROUP; # OF BEI ODMS: COST OF PROJECT; i DI MANSIONS: • 1 2 FLOOR SQ. FTG: ¢rte # OF STORIES: UNFIN BASEMENT SQ. FTG: G•1- OESQ. FTG: /e Fe) — CONSTRUCTION TYPE: DECK/COV. PATIO SQ. FTG: of4 LHEAT SbU CE: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? AUG 17 2005 14:03 5093241567 PAGE.01 ArkitatA1 www.arrow.com Weldmuller 3E