2005, 01-06 Permit App: 05000061 Patio EnclosureProject Number: 05000061 Inv: I Appfication Date: 01/06/200.5 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Parcel Number: 55082.1705 Block
SiteAddress: 3015 N JOEL RD
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District
Area: .00 Acres Width: 0
Nbr of Bldgs: I Nbr of Dwellings: 1
Lot:
Owner: Name: SCHIMMELS, GARY
Address: 3015 N JOEL RD
SPOKANE VALLEY, WA 99027
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information: .......
Review
Site Plan Review
Plan
Permi
.......... ......................... . .. .... .....
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (00()) ()()()-()000
Released By: h
Operator: K—C Printed By: K—C Print Date: 01/06/2005
Project Number: 05000061 Inv: 1Application Date: 01/06/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
"208" DRAINAGE EASEMENT SITE PLANS - SEE PLAT FILE
Payment Summary:
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: 01/06/2005
S 011' (X'kan°y ems`
Valley
-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
11 REQUIRED SITE INFORMATION 11
Street Address
�s
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
[Building Permit
❑ Relocation
�o X40,���E���E, , 9927
❑ Change in Use
❑ Tenant Improvi
4�" at t
�C
tured Home
IXC' b�C�e�i
PC
OWNER/APPLIUAN I INF-UKMA I IUN
Owner: C-4.0�///�`SGS ❑ Applicant:
Phone: p/ Fax: A Phone:
Address:aoZE[ B ~> Address:
City
❑ Contractor:
Phone:
Address
City
State Zip Code i
Fax:
State Zip Code
WA State Contractor License #:
City
❑
Architect-
Phone-
Address:
rchitect:Phone:Address:
City
Contact: G9'w
_ Fax:
State Zip Code
Fax:
State Zip Code
PERMIT/BUILDING INFORMATION 11
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2 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:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
Width: Length:
Manufacturer:
Previous Address:
Proposed Use: _
MANUFACTURED HOME
Year:
RELOCATION
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent: Fireworks Display: Blasting:
Valuation: Above/Underground Storage Tank Size:
Pit Set:
Paint Booth:
Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
❑ BOLTING
Firm Name:
Inspector(s):
Phone:
Fax:
City State Zip
Phone: Fax:
city State Zip
SPECIAL INSPECTIONS
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Fax:
❑ 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 to the property owner.
Print Name
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash )K Check
Bankcard #:
Authorized Signature:
❑ Mastercard
Expires:
❑ VISA ❑ Other
VIN#: