2003, 01-09 Permit App: 03000171 CarportProject Number: 03000171 Inv: 1 Application Date: 1/9/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Parcel Number: 45092.0719 Block: 1
SiteAddress: 2810 N JOHNSON CT
SPOKANE, WA 99206
Location:: SPO
Zoning: UR 3.5
Water District:
Area: .,453.00 Acres Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot: 5
Owner: Name: RUBERT, MIKE
Address: PO BOX 29
SPANGLE, WA 99031
Hold: ❑
Depth: 92 Right Of Way (ft): 36
Review Information:
Inf :.
..........
Revi
Site
Plan Review
Prmie 'ts
.
Operator: RMB Printed By: RMB Print Date: 1/9/2003
Project Number: 03000171 Inv: I Appticatioli Date: 1/9/2003 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Const Category: New
Nbr Of Dwellings:
Bldg W x D: x
Req Parking:
Building Permit —
Firm: OWNER
Phone:
Building Characteristics
Group: Type:
Occupant Load: Building Height:
Building Sq Ft: Sprinklers: El
Handicap Parking: Critical Materials: 0
Description Gtr Type Notes
CARPORT U-1 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Pavment Summa
This Application:
Su Ft Valuation
550 $2,475.00
Totals: 550 $2,475.00
Units
Unit Desc
1
Y OR BLANK
1
Y OR BLANK
1
Y OR BLANK
Permit Total Fees:
Stories:
Total Project:
Su Ft Valuation
550 $2,475.00
550 $2,475.00
Fee Amount
$75.50
$4.50
$16.61
$96.61
Permit Tvpe Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $96.61 $96.61 $0.00 $96.61
$96.61 $96.61 $0.00 $96.61
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: RMB Printed By: RMB Print Date: 1/9/2003
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 Vk`EST BROADWAY ANTNUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: -
Assessor's Tax Parcel Number(s): � C"
Legal Description:
Project Description: C' 00
d7guilding Permit ❑ Change in Use ❑ Grading ❑ ;Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other
Department Use Only
\Fater District/Purveyor.
Sewer District/ purveyor
Road width
Setbacks
Mailing Address:
Z ZX -
Total habitable space
21,d floor sq. ft.
Front Rear.
School District.
Fire District:
Zoning
Deck sq. ft.
Cin', Stat,, Zip
❑ Co racnx
Left: Right.
OWNER/APPLICANT INFORMATION
PIr.,,c,,,,,, ,,,E,,, b it h, a;»„ IN,
❑ (hs-ncr:
Building height to Peak
Phon,:
L�G��''-%�—C
❑ Applicant: Phone
Mailing Address:
Z ZX -
Total habitable space
21,d floor sq. ft.
Mailing :Address:
Cin, State, Zip
Construction type
Garage sq. ft.
Deck sq. ft.
Cin', Stat,, Zip
❑ Co racnx
Ph.roe
Phone
❑ Architect/1�: nc•e,�
Mailing address
Mading addre s
Cin-, State Lip
Cin', State Zip
\C'A State Contractor licens, #
Contact name:
PROIECT INFORMATION
Building Information
Building height to Peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
21,d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
IIcat source (electric, gas, etc.)
Manufactured Home
Sign
Width:
length:
What is the square footage of the sign
faCe?
I low high is the sign?
Year:
Iclake:
# of signs
Arca of existing signs
0 Don't know 0 Yes Oho
Is the property located within 1000 feet of a Natural Resource Area?
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
Precious address
mire Sprinkler 'fent
Paint booth Dire ,Varm Fireworks display"
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
firm Name Phone
Plans Examiner Phone
Inspectors:
Address
If �es,identi �on.rite Inn 0 Yes C1 �ofl(Gltt�t-
Inspector Phone
0 Concrete 0 Welding O Bolting 0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 13 Yes 0 No
\\'hat is the current property size?
I yes, identi , on site lan %1 C ee c,---
(square feet or acres)
Is any part of the property within 250 feet of a shorelines
What is the cur�rn¢.yi1t use of this property?
If �es,identi �on.rite Inn 0 Yes C1 �ofl(Gltt�t-
0 No
Is your property in a designated wildlife habitat area?
Will t site be served " a septic wstem? 0 Yes 0- No
0 Don't know 0 Yes Oho
Is the property located within 1000 feet of a Natural Resource Area?
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
I f f -es, idenlo, on site plan
I_fyes, idenlih, on the site plan 0 Yes CYNo
0 \laybe 0 Don't know 0 Yes 0 --Ko
Are there any wetlands, streams or ponds within 200 feet of the property?
Is there evidence of fill or excavation on the property?
1 yes, identi O on site lan 0 Yes C1 No
O Yes C3 -No
Are there slopes greater than 3W/,) on the property? (30 ft rise in 100 ft)
Are critical or hazardous materials used or stored on site?
010 0 Yes C3 No
0 Yes (73 --No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control .Area?
0 Yes
O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes
0 No
Is public water available to the site? 0 Yes 0 No
0 Yes
0 No
COUNTY PERNIff CENTER
Is the property inside the PSSA? 0 Yes
0 No
Is the property located within 1000 feet of a Natural Resource Area?
0 Yes 0 No
Date Received: Staff RePresen Gibe,
METHOD OF PAYMENT
❑ CIASI I ❑ cl ircK ❑ � ❑ ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
I)XI'1
B:ANK(::ARl) NU,'\IBI•:R:
1U"111081""/.I{t) SIGN:\'PURI?:
SUBTOTAL
,
TOTAL FEE
MINIMUM PERMIT FEE IS S3509PLE ASE
MAKE 0IECKS PAYABLE TO SPOKANE
COUNTY PERNIff CENTER
"1,6- 1
F -M
10 A A,5 r im-
f
ADD
ZON
ROA
F
Cori
REV
BUILDING AND CODE ENFORCEMENT
James L. Manson, C.B.O., Director
Mike Ruben
PO Box 29
Spangle, WA 99031
RE: Address Change - Parcel No. 45092.0718
Dear Mr. Rubert:
L C O U N T Y
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
Gary Ober& Director
September 12, 2002
Please be advised that in order to better identify your temporary residence this office has found it necessary to revise your
current address from 11208 E Grace Ave to N 2810 Johnson Ct.
It is extremely important that the following items be accomplished as soon as possible and remains as assigned:
1. Post your address for emergency vehicle purposes, as required in Section 10.208 of the Uniform Fire Code.
2. Notify your post office of your address.
3. Notify your telephone company of the change.
We sincerely regret any inconvenience this revision may cause. Please feel free to contact this office between the hours of
8:30 a.m. and 5:00 p.m., weekdays, should you have any questions.
Sincerely yours,
7.A)L
Carol Frazier
Building Technician
CF/dt
c: Spokane Regional Health District
Spokane County Assessor's Office
Fire District No. 1
Division of Utilities
Election Department - Laurie Patton
911 Administration - Gary Richards
Combined Communication Center - Luke Cussins/Roger Smith
U.S. Postal Service
Division of Engineering & Roads - Sylvia Lightfoot
1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050
PHONE: (509) 477-3675 9 FAX: (509) 477-4703 9 TDD: (509) 477-7133