2005, 08-19 Permit App: 05003009 AdditionProject Number: 05003009 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 08/19/2005 Page 1 of 2
Project Information:
Permit Use: 16 X 14 ADDITION TO RESIDENCE
Setbacks: Front 25 Left: 7 Right: 5 Rear: 55
Site Information:
Plat Key: 002367 Name: SHERWOOD FOREST
Contact: BRICKERT CONSTRUCTION
Address: PO BOX 459
C - S - Z: POST FALLS, ID 83877
Phone: (208) 777-7504
Group Name:
Project Name:
District:
E
Parcel Number: 45203.1307 Block:
SiteAddress: 903 S MARIAM ST
Location:: CSV
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: .00 Acres
Lot:
Owner: Name: WILLITS, SHARON J
Address: 903 S MARIAM ST
SPOKANE VALLEY, WA 99206
Hold: ❑
Width: 80 Depth: 130 Right Of Way (ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Released By:
Plan Review
Originally Released: 08/19/2005 By: cjjanssen
Released By:
Sewer Review
Permits:
Originally Released: 08/19/2005 By: TSCHOLTE
Released By:
Originally Released: 08/19/2005 By: cjjanssen
Operator: CJJ Printed By: CJJ Print Date: 08/19/2005
Project Number: 05003009 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 08/19/2005 Page 2 of 2
Building Permit
Contractor: BRICKERT CONSTRUCTION CO Firm: BRICKERT CONSTRUCTION CO
Address: PO BOX 459 Phone: (208) 777-7504
POST FALLS, ID 83877
Building Characteristics
Total Area 224
Building Height 12
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Iya Notes Sq Ft Valuation Si Ft Valuation
RES ADD R-3 VB ADDITION 0 $32,000.00 0 $32,000.00
TO
RESIDENCE
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Notes:
Payment Summary
Permit Type
Building Permit
Totals: 0 $32,000.00 0 $32,000.00
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Fee Amount
$461.95
$4.50
$184.78
$651.23
Fee Amount Invoice Amount Amount Paid Amount Owing
$651.23 $651.23
$0.00 $651.23
$651.23 $651.23 $0.00 $651.23
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: 08/19/2005
BUILDING PERMIT APPLICATION WORKSHEET
SAM City of Spokane Valley Community Development Department
-ECZBuilding Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
jUalley 1(&.! (93
REQUIRED SITE INFORMATION
of
Street Address: Ci 5
Assessor's Tax Parcel Number(s):
Legal Description:
(07://7/ Eck oe, -2r-046--67—
&id( hoe,5-1-
PERMIT DESCRIPTION:
Building Permit
0 Relocation
❑ Change in Use 0 Grading 0 Manufactured Home
0 Tenant Improvement 0 Fire Safety ❑ Other
0 Owner:
Phone:
Addre
(Sad:
City
OWNER/APPLICANT INFORMATION
-)i 1/1 /5--- ❑ Applicant:
Fax: vLiviar, Phone: Fax:
�'s 5 A - Address:
.WiifijinfiRZY
0 Contractor:
Phone:2
ddress:
a.S i tc. l (s,
State ip C•de
City
E/Z J
7 7Fax:20 Architect:
a
$-77,3 —7!'74
State Zip Code
City
State Zip Code
Phone: Fax:
Address:
City
State Zip Code
• WA State Contractor License itA t/ C'/Cc f ontact: + 'o al � 2 Z - -24 7 Z
Spokane Valley Bus. Liscense #: Contact
PERMIT/BUILDING INFORMATION
HEIGHT TO vZ �EAK:
DIM �NSIO NQS: b.t �
eo FLOOR Sp. FTG:
# OF STORIES:
UNFIN BA�SEEM SQ. FTG:
MAIN D0XA2 TQ SQA FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ FTG:
DECK/COV. PATIO SQ. FTG:
®O
OCCUPANCY GROUP:
n. k
CONSTRUCTION TYPE:
H SOURC
1i12C 'Ai2
` 7
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
OF OF PRdJ T:
,5Z/ e U u
30% SLOPES ON PROPERTY:
SEWER�OR ON-SITE SEPTIC
S M?
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
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 deel pme t rights granted by any issued p inure to the property o
Print NanEk.. - CJ a ctJ Signatu
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #:
Authorized Signature:
Expires:
VIN#:
❑ Other
I
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BRICKBAT CONSTRUCTION CO LLC . •
P.O. BOX 459
POST FALLS, ID 83877-0459
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