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2002, 10-23 Permit App: 02009412 Perm RelocationProject Number: 02009412 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/23/2002 Page 1 of 3 Project Information: Permit Use: PERMANENT RELOCATIONS OF RESIDENCE & Contact: RUBERT, MIKE GARAGE - NATURAL GAS Address: PO BOX 29 C - S - Z: SPANGLE, WA 99031 Setbacks: Front 3,c, Left:40 Right: (1 Rear: 7 Phone: (509) 448-2720 Group Name: Site Information: Project Name: Plat Key: 006229 Name: CHRISTIN'S ADD District: H Parcel Number: 45092.0719 Block: 1 Lot: 6 SiteAddress: 2816 N JOHNSON CT Owner: Name: RUBERT, MIKE SPOKANE, WA 99206 Address: PO BOX 29 Location:: SPO SPANGLE, WA 99031 Zoning: UR 3.5 Water District: Hold: Area: 0 Sq Ft Width: 150 Depth: 300 Right Of Way (ft): 36 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Site Plan Review Released By: C,4tattAiu 10,23-0 Plan Review Released By: gitAs 101JUV /0.1,3,02, Approach / Drainage 09..V-0 I Permits: e"O2 cri4 Operator: CKF Printed By: CKF Print Date: 10/23/2002 Project Number: 02009412 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/23/2002 Page 2 of 3 Contractor: OWNER Const Category: New Nbr Of Dwellings: Bldg W x D: x Req Parking: Description Gni BASEMENT U R-3 FOUNDATION R-3 Building Permit Firm: OWNER Phone: Building Characteristics Group: Type: Occupant Load: Building Height: Building Sq Ft: Sprinklers: El Handicap Parking: Critical Materials: ❑ This Application: Type Notes Sq Ft Valuation VN 770 $9;471.00 VN 280 $560.00 Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Contractor: OWNER Item Description GAS WATER HEATER GAS APPLIANCE<=100,000BTU GAS PIPING VENTILATING FANS CLOTHES DRYER Contractor: OWNER Item Description TOILETS/BIDETS SINKS TUBS CLOTHES WASHER FLOOR DRAINS MINIMUM FEE ADJUSTMENT Operator: CKF Totals: 1,050 $10,031.00 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK Permit Total Fees: Mechanical Permit Units 1 1 2 2 1 Stories: Total Project: Sq Ft Valuation 770 $9,471.00 280 $560.00 1,050 $10,031.00 Fee Amount $175.50 $4.50 $38.61 $218.61 Firm: OWNER Phone: Unit Desc NUMBER OF NUMBER OF # OF UNITS NUMBER OF NUMBER OF Permit Total Fees: Plumbing Permit Finn: OWNER Phone: Units 1 1 1 1 1 1 Unit Desc NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF Select Permit Total Fees: Printed By: CKF Print Date: Fee Amount $10.00 $12.00 $2.00 $20.00 $10.00 $54.00 Fee Amount $6.00 $6.00 $6.00 $6.00 $6.00 $5.00 $35.00 10/23/2002 Project Number: 02009412 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/23/2002 Page 3 of 3 Contractor: OWNER Relocation Permit Firm: OWNER Phone: Item Description Units Unit Desc Fee Amount RELOCATION INSPECTION 1 NUMBER OF $50.00 Notes: Permit Type Building Permit Mechanical Permit Plumbing Permit Relocation Permit Fee Amount $218.61 $54.00 $35.00 $50.00 Permit Total Fees: $50.00 Invoice Amount $218.61 $54.00 $35.00 $50.00 Amount Paid $0.00 $0.00 $0.00 $0.00 Amount Owing $218.61 $54.00 $35.00 $50.00 $357.61 $357.61 $0.00 $357.61 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fmds 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: CKF Printed By: CKF Print Date: 10/23/2002 Ail SPOKANE COUNTY PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: 2 (,i Trr Kd .b ( J Assessor's Tax Parcel Number(s): Legal Description: Project Description: '')'1 e to Tou itch 741 0 k -OIa --yvCOUe O #t 62 OILS 4a Its tsuilding Permit O Change in Use O Grading O Manufactured Home Permit O Relocation tEl Sign O Tenant (New/Change) O Other Department Use Only Water District/Purveyor: Sewer District/Purveyor Road o nh h Setbacks Front Rear: Left: Right School District mire District: Zon lug OWNER/APPLICANT INFORMATION 0 Indicate who should be Contacted reeardinn this nYr ect Itr6wvner. / r l l4 ke--• f?u e10-71-- Phone: Fax: iq —_2 7_20 /me I 18 7.21, CI Applicant: Phone: Fax: Mailing Address: P© lox c,2? I finished basement sq. ft. Occupancy oup S i Kq 1e -ea m e (.9 Mailing Address: Garage sq. ft. 141. 2B'OCost City, ,SState, Zip JPQKq /., /_ i k ct leat source (electric, gas, etc.) 0 a s 99623 / City, State, Zip CIContractor eJ Phone Fax ❑Architect/Fingineer Phone hex Mailing address Mailing address City, State Zip City, State Zip WA State Contractor license z Contact name: PROJECT INFORMATION Building Information Building height to peak %L/' # of stories / Main floor sq. ft.CP 770 Unfinished basement sq. tt. 77U Dimensions I / 2-2 x3_5 'total habitable space 2'i floor sq. ft. I finished basement sq. ft. Occupancy oup S i Kq 1e -ea m e (.9 Construction e t c A.anM.L Garage sq. ft. 141. 2B'OCost beck sq. ft. ofproject oI 400 �� leat source (electric, gas, etc.) 0 a s Manufactured Home Sign Width: Length: What is the square footage of the sign face? I low high is the sign? Year: Make: # of signs Area of existing signs Fireworks display Are critical or hazardous materials used or stored on site?? 0 Yes o Proposed use Value Relocation Fire Safety Finn Name What is the c`iijent use of this_`property? a V G& fz7 Previous address Will the site be served by a septic system? D Yes LIYls Paint booth Fire Sprinkler Tent Fire Alarm Fireworks display Are critical or hazardous materials used or stored on site?? 0 Yes o Proposed use Value Special Inspections Required? Non -Residential Energy Code Compliance? Finn Name What is the c`iijent use of this_`property? a V G& fz7 PI, Inc Will the site be served by a septic system? D Yes LIYls Plans Examiner Phone Inspectors: Is there evidence of fill or excavation on the property? 0 Yes ®-IVo Are there slopes greater than 30% on the property? (30 it in 100 ft) ( /%) 0 YesNo Are critical or hazardous materials used or stored on site?? 0 Yes o Address Inspector Phone D Concrete D Welding D Bolting D Reinforcement Address ITIONAL SITE INFORMATION Are there structures on the property? D Yes OrNo Ifyes, ident,6 on site plan What is the current property size? 66 (square feet or acres) / / 0 0 Is any part of the property within 250 feet of a sho59er If yes, ident on site plan D Yes No What is the c`iijent use of this_`property? a V G& fz7 Is your property in a designated wildlife habitat area?% D Don't know D Yes erNo Will the site be served by a septic system? D Yes LIYls Is any part of the property within a 100 yr flood plain? Ifyes, identi on site planIfyes, D Maybe D Don't know D Yes No Are or will there be wells located on the property? i identO, on the site plan D Yes I.1v o Are there any wetlands, streams or ponds within 200 of the property? Ifyes, identt on site plan D Yes No Is there evidence of fill or excavation on the property? 0 Yes ®-IVo Are there slopes greater than 30% on the property? (30 it in 100 ft) ( /%) 0 YesNo Are critical or hazardous materials used or stored on site?? 0 Yes o DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? DYes 0 N Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? 0 Yes 0 No D Yes 0 N Is public water available to the site? 0 Yes 0 No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? D Yes 0 N Date Received: Staff Representative: METHOD OF PAYMENT VISA 0 CAST I CHECK 0 111111111111111 0 p :" 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: SUBTOTAL TOTAL FEE MINIMUM PERMIT FEE IS $35.A0 PLEASE MAKE CHECKS PAYABLE TO SPOKANE COUNTY PERMIT CENTER , ADDRESS f Z ZONE (kA j . un A n w1IITI' J(�•, FRONT 3i(� tiNKING'1O COMMENTS GRACE AVENUE RF Vi r. • i'p .400 8.6' 8' 55' SETBACK LINE (FROM CENTERLINE) 55' SETBACK 'LINE (FROM CENTERLINE) This site plan is being s! bmitted far the •LuT se of obtaining a b.,,id,ng permit and is a true on. ,orrect _pepcaseatation_of the wbposai. All known :. •perty • es/dimensions. curb lines. structures a . ;asemelts nds, r er c reas. ep sip. ✓" 0 SWALE BOTTOM DIM.: (AS SHOWN) BOTTOM OF SWALE= 1996.00 AREA= 630 S.F. 1 TYPE B DRYWELL SPOKANE COUNTY STD. B-10 W/ TYPE 4 FRAME & GRATE STA. 24-88.85, 27' RT. (GRACE) RIM ELEV.= 1996.50 0 CURB INLET TYPE 2 SPOKANE COUNTY STD. B-9 STA. 2+73.44 (GRACE) EL.= 1996.86 (FLOWLINE) 14' BORD R EASEMENT 20 ave • nen bodies of water, Signed: Date: 10 ( IN FEET ) 1 inch = 20 ft. STORHAUG ENGINEERING 1322 NORTH MONROE SPOKANE, WA 99201 (509) 242-1000 CHRISTIN'S ADDITION 208 LOT PLAN LOT 6, BLOCK 1 DJT DATE: 04/24/02 DRAWN BY: JAM/ CHECKED BY: MOW PROJECT No.: 00-051