2003, 06-30 Permit App: BD-03-721 MHfC 11707 E. SPRAGUE, STE 106
Vali SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMITTAL:
TRANSMITTAL DA IE:
• PERMIT INFORMATION
Site Address: l e (3S E t is i ✓\
Parcel Number: c/ 3 /. a 2_l
Subdivision: A r rnsfro.7,5
Block: 2 Lot:
Zoning: Water Dist:
Owner: aDn C yv-4_
Address: 1.33/0 1 IS S
Building Inspector:
Permit Number:0 63 -7,� ( Issue Date:
Permit /(v1et P Use: , �� LtJ c�'61 /fit
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Applicant: ‘
Phone:
Contact:
Phone: ;I(aq.17j-7)
Contractor:
Setbacks — Front: Left: Right: Rear:
APPROVALS
PLANNING:
ENG ! ERS: E)C (S/I —
NATER DIST:
APPROVALS
:TORMWATER:
)TE ER:
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Site Information
Project Information
Site Address: 16605 E MAIN AVE
VERADALE, WA 99037
Parcel Number: 45134.2321
Subdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: GANT, DONALD
Address: 13310 E MISSION AVE #14
SPOKANE, WA 99216
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 03004655 Inv: 1 Issue Date: 7/1/2003
Permit Use: SEWER CONNECTION - WHITE BIRCH (ARMSTRONG
EST)
Applicant: HOMEBOYS CONSTRUCTION
14525 N NEWPORT HWY
MEAD, WA. 99021 Phone: (509) 468-1750
Contact: HOMEBOYS CONSTRUCTION
14525 N NEWPORT HWY
MEAD, WA. 99021
Setbacks - Front:
Group Name:
Project Name:
Left: Right:
Phone: (509) 468-1750
Rear:
Permits
Sewer Connection Permit
Contractor: HOMEBOYS License #: HOMEB**033PC
SEWER CONNECTION
1 $85.00 PROCESSING FEE
Total Permit Fee:
FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES 8:34-5:00 PM MONDAY THRU FRIDAY
$15.00
$100.00
Call for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRED.
Contractor or applicant is to field locate and confirm the elevation andposition of sewer stub prior to any other excavation.
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main sewer.
Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure.
This permit must be presented to the job site inspector for verification. To locate buried cables, gas piping, water lines, etc.
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE' CALL BEFORE YOU DIG" CENTER BE
NOTIFIED. CALL BEFORE YOU DIG AT LEAST 2 WORKING DAYS IN.ADV NCE, (509)456-8000.
Spokane County Code requires the installer comply with all requirements of the Washington State Dept of Labor and Industries, including
those related to trench safety.
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date Receipt # Payment Amt
7/1/2003 4172 $100.00
Processed By: SHATTO, JULIE
Printed By: WENDEL, GLORIA Page 1 of 1
PERMIT
(,o
APPROVED BY
City of
SPOKANE VALLEY
PERMIT # .72/
BUILDING PERMIT APPLICATION
Box 1 OWNER f)o,/ (3A-74 JOB LOCATION
OWNER'S ADDRESS /4'3&0 Inis$'o4 CITY SP.►/. PHONE 92.
0 alb
/7
DESCRIBE JOB A/Ee4,J its C GJ( St -a ,..St/P0O421 .7--( a � � � C 44146 -
1c( s'zea We, PL'y
THIS PROPERTY IS OWNED BY: SINGL
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME }o A c f$'}y
PHONE g' / 751J
CONTRACTOR'S ADDRESS NdLfS f14.)P1 Cf CITY %Lt -C -
CONTRACTOR'S REG.# TIOfua • 033 fC EXPIRATION DATE 2i0 Li
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECTy� l SIC Laoi), 06) PHONE 46 8 -
ADDRESS
CITY ZIP Q91)
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY `t9 6 -
BOX 5 ESTIMATED PROJECT COST $ / `A9 OM? EXISTING BLDG. VALUATION $ 9.5( eaD
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4'S/ 3
LEGAL DESCRIPTION
Go �' 0-1 Rezcie /4-Anksie.!, /46
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR / OTHER
BASEMENT UNFINISHED /
CARPORT / TOTAL
DECK
1ST FLOOR ,?G '/ 2ND FLOOR
BASEMENT FINISHED
/ GARAGE /ZO /
/ HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ()() SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins)
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size (if known) (1I Also see BOX 4
BOX 11 Septic Tank — Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST•'`KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERF PE WORK FOR WHICH THE APPLICATION IS MADE.
OW =� -
NER _-. _ . � `� DATE 6)\ep`fb�
(OVER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard
Expiration Date
Print the name of the Holder Signature
DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES.
OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
REMARKS
DISAPPROVAL DATE
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
PUBLIC WORKS DEPARTMENT APPROVAL
DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
ASSIGNED ADDRESS
Received
DATE