2009, 08-31 Permit App: 09002647 ResidenceProject Number: 09002647 Inv: I
Application
Date: 8/31/2009 Page 1 of3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SFR W/ATT GAR Contact: HOMESTEAD CONSTRUCTION, INC
Address: 212 S FARR RD
C - S - Z: SPOKANE, WA 99206
Setbacks: Front Left: Right: Rear: Phone: (000) 000-0000
Group Name:
Site Information: Project Name:
Plat Key: Name: Range
-1
District: East
Parcel Number: 55182.3901
Block: Lot:
SiteAddress: 17102 E MAXWELL AVE
Location:: CSV
Owner: Name: HOMESTEAD CONSTRUCTION, I
Address: 212 S FARR RD
SPOKANE, WA 99206
Zoning: R-4 SF Res Urban District
Water District: 134 CONSOLIDATED ID #19
Area: 6,881 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information •
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Released By:
Driveway/Approach
Originally Released: 8/25/2009 By: tmelbourn
Released By:
NOT REQUIRED
Originally Released: 8/31/2009 By: TMELBOU
Landuse/Zoning/HE Conditions
Released By:
See ADE -04-09 for approved 14 foot flanking street setback.
Originally Released: 8/31/2009 By: mpalaniuk
Operator: JD Printed By: jmm
Print Date: 8/31/2009
Project Number: 09002647 Inv: /
Application
Date: 8/31/2009 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Sewer Review
Released By:
Originally Released: 8/21/2009 13y: jdavis
Permits:
Building Permit
Contractor: HOMESTEAD CONSTRUCTION Firm: HOMESTEAD CONSTRUCTION
Address: 312 S FARR RD Phone: (509) 892-0454
SPOKANE, WA 99206
This Application: Total Project:
Description C - Type Notes Sq Ft Valuation Su Ft Valuation
I&2 FAMILY R-3 VB 884 $85,597.72 884 $85,597.72
2ND FLOOR R-3 VB 707 $52,798.76 707 $52,798.76
BASEMENT U R-3 VB 496 $7,440.00 496 $7,440.00
DECK OPEN R-3 VB 80 $1,200.00 80 $1,200.00
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW <7999 SQ FT
Totals: 2,167 $147,036.48 2,167 $147,036.48
Units Unit Desc Fee Amount
1 SELECT $1.262.55
I SELECT $4.50
I SELECT $505.02
Permit Total Fees:
Mechanical Permit
$1,772.07
Contractor: HOMESTEAD CONSTRUCTION Firm: HOMESTEAD CONSTRUCTION
Address: 312 5 FARR RD Phone: (509) 892-0454
SPOKANE, WA 99206
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
VENTILATING FANS 1 DUCT
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
5 NUMBER OF
Operator: JD Printed By: jmm
Fee Amount
$11.00
$13.00
$55.00
Permit Total Fees: $79.00
Print Date: 8/31/2009
Project Number: 09002647 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/31/2009
Contractor: HOMESTEAD CONSTRUCTION
Address: 312 S FARR RD
SPOKANE, WA 99206
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Notes:
Plumbing Permit
Page 3 of 3
Firm: HOMESTEAD CONSTRUCTION
Phone: (509) 892-0454
Units Unit Desc
3 NUMBER OF
5 NUMBER OF
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$18.00
$30.00
$6.00
$12.00
$6.00
$6.00
$6.00
$18.00
$102.00
A 6 -FOOT HIGH SIGHT -OBSCURING FENCE MUST BE INSTALLED AROUND PERIMETER
OF VALLEY COACH ESTATES SUBDIVISION PRIOR TO ANY BUILDING PERMITS -MH
THE FENCE HAS BEEN INSTALLED. BUILDING PERMITS FOR VALLEY COACH ESTATES
ARE OKAY -MH
Payment Summary: , _...
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,772.07 $1,772.07 $422.14 $1,349.93
Mechanical Permit $79.00 $79.00 $0.00 $79.00
Plumbing Permit $102.00 $102.00 $0.00 $102.00
$1,953.07 $1,953.07
$422.14 $1,530.93
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 he 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: JD Printed By: jmm Print Date: 8/31/2009
Spokane
Valley
Community Development
Residential Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
PERMIT NUMBER. t(77
PERMIT FEE:
Fvf New Construction Accessory Bldg
❑ Addition/Remodel ❑ Deck
In Other:
SITE ADDRESS:
ASSESSORS PARCEL NO: SS\"45\ c..-‘,\ LEGAL DESCRIPTION: \ \ \ \wc�
Describe the scope of work in detail:
Cost of Project: $
Proposed Use:
•,.....nm L_ _ ..>leae. r....:to N/A if nnf annlirahlrl**********************
• •, 1 ne louuwrug' lvlvos uc wmpn.w......... ..,-- .- ___-rr-------i
Building '
Owner: _.: :.... .: ,•,..,," _ .-.'-`.
o
Contraetr: f . T
_-s<1.:... - : •.�, _ .- :. „ : , . ..
Name: U ( \\
Name:
Address: . \
Address:
Zip ;.\-\
Ci State' \ a
ry'
City: State: Zip:
Phone: 1/4')%1' c%‘-
Fax:
Phone: Fax:
FINISHED BASEMENT NIA.
SQ. FTG: 'ia
Contractor Lic No: Exp Date:
Contact Person
30% SLOPES ON —
PROPERTY:
City Business Lic. No: \'tc\ ‘E---\.gQz,ThC
Name: L\-. S% c..:.
HEAT SOURCE:
' C-3�
SEWER OR SEPTIC?
sewps, cQ,..�
Phone: Th c m_- \4c..,`t
Describe the scope of work in detail:
Cost of Project: $
Proposed Use:
•,.....nm L_ _ ..>leae. r....:to N/A if nnf annlirahlrl**********************
• •, 1 ne louuwrug' lvlvos uc wmpn.w......... ..,-- .- ___-rr-------i
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE O TO SPACE:
SA
MAIN FLOOR TO SQ.
FTG c , / ^
2n" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT NIA.
SQ. FTG: 'ia
-GARAGE SQ. FTG:
DECK/COV. PATIO SQ. F G:
30% SLOPES ON —
PROPERTY:
CONSTRUCTION TYPE:
HEAT SOURCE:
' C-3�
SEWER OR SEPTIC?
sewps, cQ,..�
# OF BEDROOMS:
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 ow:ier. 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE:
Vu
Method of Payment:
0 Cash
Bankcard #:
Authorized Signature:
REVISED 2)15107
❑ Check
❑ Mastercard
Expires:
DATE: % RFC 7, -O BY
CITY ' AVE VALLEY
AUG 2.1 2009
I-criivllz CEN I cR
❑ VISA
VIN#:
BY:
' 11711707 Permit Sprague
'iIIC E Spque Ave, Suite 106
Walley Spokane Valley, WA 99206
(509)6ES-0036 FAX (509)688-0037
Community Development www.slr+kanrvallrv.orq
Mechanical Perm _ it Application 0 Commercial 171 Residential
PERMIT NUMBER:
PERMIT FEE:
SITE ADDRESS:
\c>
Building
Building Ow Der
\'
c -c .' - : '.,' , 2C ..
.
Nam::
Plena: •
Paz:
Address:
City.
State: -
Zip:
Conutactt
'.
Name:
Phi=
Pax:
Adds+:
City:
State:
Zip:
ILccse Nc:
_
City Badness Ila
Contact- - - ...
: ; : , � _ ....,
S - ..?,+:1S01,#37'''
- -
Hama:
DESCRIPTION OF WORK
/ OP UNITS
1
FUEL BURNING APPLIANCE
Eatgl b or Moe then 100,000
X
COST
;12.00
•
TOTAL AMOUNT
•
2
FUEL BURNING APPLIANCE
Mon than 100,000
$15.00
3
UNLISTED APPLIANCE (Additional Fee)"
Equal b ct No than 400,000
X
;50.00
4
UNLISTED APPLIANCE (Add!lbnal Fee)
Wry tan 400.000
X
;100.00
5
6
USED APPLIANCE (WSEC'm!n. AFUE Ming)
USED APPLIANCE (WSEC min. AFUE Wino)
Eald b at Moo then 400.000
7
BOILERREFRIGERATION
MOtaten 400,000
1-10044 BTU
X
X
;50.00
$100.00
X
;12.00
•
e
OILER^2E FR IGERATION
10L• 50044 BTU
X
120.00
e
BOiLERHEFRIGERATION
10
BOI LERI1 E FRIGERATI ON
601-1.00044 BTU
1,001-1.76044 BTU
X
X
;25.03
$35.03
11
B O L E R.. t E FR I G E RATI ON
12
GAS LOG, GAS INSERT, GAS FIREPLACE
More then 1,76044 BTU
X
X
;60.00
;10.00
13
RA::G'e
X
$10.00
14
OTTER
X
;10.00
15
FUEL BURNING WATER HEATER
X
$10.00
16 l.IISC. FUEL BURNING APPLIANCE
X
$10.00
17 GAS PIPING (each outlet
18 DUCT SYSTEMS
'X
X
$1.00
;10.X1
19 \ ENTLkTING PANS
. JR H-NDLER (DOES NOT Indude'du frwi)
21 .-JR KANDLER (DOES NOT Include ducMq)
22 ,NAPCR.TNE COOLERS
Earl b or Mitten 10,000 CPM
X
X
;10.00
$12.00
ORM; ton 10.000 CPM
X
;15.00
X
;1000
23
24
25
26
io
30
TYPE I f ICOR
X
TYFE II HOOD
X
HEAT PULP/AIR CONDITIONER .
0-3 TON
X
.JR CONDITIONER
3-15 TON
X
.Ji. CC.:DRIONER
10-30 TON
X
,-JR CCt:DRIONER
FIR CCNDITIONER
10414 TON
Moro taut 60 TON
X
.20 STORAGE TANK.
X
31 APIC. CR PELLET STOVE/1NSERT
X
$50.00
;10.00
$12.00
;20.00
;26.00
;35.00
;60.00
;10.00
;10.00
•
•
•
•
32 vro:a: STOVE - FREE STANDING
X
;23.00
33
ADDRIONS
X
;15.00
34
VE1:::LATION SYSTEMS
X
;12.00
35
'/ENT.L.TION MECHANICAL EXHAUST
X
$12.00
36
INCIHER.:TOR - RESIDENCE
X
;10.00
37
C.NER..TOR - COMMERCIAL
X
$2200
:S. ; 400 OJ PAYMENT:
OG. : ❑ CHECK ❑ VLSA ❑ 1.4C
CI PD
RUM, ORI?HD SIGNATURE:
sat) ettLet
/+TOTAL
PROMISING PEE
$35.00
TOTAL PERMIT PIE DUE:
O namotl y D•velopmmt
Plumbing Permit
Pant Center
11707E Sprague Ave, Sulo 106
Spokane Valley, WA 99206
(309)681-0036 FAX (309)688-0037
www foleilomenllevorzmm
Application
PERMIT NUMBER:
PERMIT FEE:
0 Commercial [73 Residential
IIR ADDRESS:
\\ \\\-\ \
anm iDlr•aPc'
1 Ca\1'wlvC.4.If.V.}:.µ �e�,p�..KZ .. .::: � ... 5•t4.�('.i "r :.mo. :.,.:.
.. . _.
imus
COST
•
TOTAL AMOUNT
1
Phone:
Fax
area
10.00
•
2
City: 8ms
Zip:
• O .t ... ... ..
.. ..
.r:.... .....,.i
..
,u
n•y
1
X
10.00
•
I
Phone:
Fax:
\
&best
14.00
-
(
City: Skits
VIPI
S ,
kens-iii-
eetiefiJ�N
18.00
•
I
City BusinenIlm
License Nee
\
X
+r
,.F:. .
y:i+
r`.P.v7:J:agki Y:
ti: i5i .., 4:.:Y-:.'aM°,+,rciLSA'7!�F.,,'F.
':^+::,._ _
me:
10.00'
•
6
Phone:
AUIHOAUZED SIGNATURE:
xavLUD 11246
DESCRIP11ON OF WORK
• OF UNITS
X
COST
•
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
10.00
•
2
URINALS1
X
0.00
•
3
TUBS
1
X
10.00
•
4
SHOWERS OPER TRAP)
BATH, STALL ONSITE BUILT
\
X
14.00
-
6
un
LAVE/BASINS. BAR, FLOOR, KITCHEN,
LAUNDRY, UTIUTY, JANITOR, PHOTO,
X-RAY. F000. PREP/CULINARY MEAT
S ,
X
18.00
•
0
DISHWASHER
\
X
10.00
•
7
CLOTHES WASHER
\
X
10.00'
•
6
GARBAGE DISPOSAL
X
60.06
•
9
WATERSOFTENER'
. .
X
10.00
•
10
ELECTRIC HOT WATER TANK • '
• .. NOTE: IF 9AS, SEE 1AEC%W1ICAL
X
10,00
•
11NS
/LRE& CASE. COIENCH.
L,TRCONDENSATE
\
x
' 10.00
•
12
EJNFIGY
DRWNS
x
0600
•
.
11
Pampas,
1
X
16.00
•
14
WATER PW$GORA WASTE,
PLUMBING, REVERSN.
NSTALLATION,ALTERATION, REPAIR,
REVERSALS
X
1600
•
10
SEWAGE EJECTOR •
• GRINDER SUMP PUMP
X
16.00
•
16
WATER USOIG DEVICE
ICE ANIOR COFFEE MAKER HOSE BIB,
' STEAMER
PROOFER, CARBONATOR,q SWAMP COOLER
23
X
10.00
•
17
CROSS CONNECTION OEVICE
VACUUM BREAKER, CnECK VALVE,
AND R,P.B.P.D. F0it TANKS, BOILERS
X
16.00
•
/B
INTERCEPTORS
T11VA7S,
GREASE MAP. T"_TRAP'
CHEMICAL HOLDING TANK
X
00.00
•
10
MEDICAL GAS tie WW1
NITROUS, OXYGEN
X
1600
•
20
MISCELLANEOUS PURSING
Fvmn
X
1600
•
21
PRIVATE SEWAGEDI$DOSAUSYS
X
620.00
•
12
INDUSTRIAL WASTE
610.00
•
HT>JORX
MEMO OF PAYMENT:
❑ cAsn ❑ CHECK . - ❑ VESA ❑ MASTERCMO
CIS EXPIRES:
atom
PROCESSING FEE
335.00
TOTAL PERMIT FEE WE:
AUIHOAUZED SIGNATURE:
xavLUD 11246
Spokan�
jUalley
Community Development
ROW Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite 8-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.sookanevalley.org
J
PERMIT NUMBER:
PERMIT FEE:
Driveway ❑ Pavement Cut **(see below)
❑ Sidewalk ❑ Curb & Gutter
❑ Other
Road Obstruction ❑ No n Yes (traffic control plan required)
PROJECT ADDRESS \1\02 E \`nc\.i,
START DATE c� � -��
ANTICIPATED COMPLETION DATE • \\ w ��
Building Owner:
Contractor:
Name: \\-m C
Address: S. `�\� �« 0.
City: \ . \ State: Zipspoil�1/4,a
Phone: �t\•L.-\Fax: J.5c\ cf',,, \
Contact Person C \<•
Name:
Phone:
\o< . S. '"-P-C?"Ci oc�
q2%
**MUST BE COMPLETE IF PAVEMENT CUT**
Name:
Address:
City:
State: Zip:
Phone:
Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Tier
Policy
Type of Work Condition of Cut
Gas Sawcut
Electric Grind (pre -approved only)
Water
CATV
Communications
Sewer
Other
Type of Repair Existing Road Condition
Asphalt Depth of Asphalt
Concrete Depth of Gravel
Asphalt Concrete
Width Length Width Length
X X
X X
X X
Locate Ticket #
BOND/INSURANCE CERT #
Signature
Method of Payment:
0 Cash
Bankcard 11:
Authorized Signature:
❑ Check
(PER SVMC TITLE 10 ARTICLE 2)
Date
❑ Mastercard 0 VISA
Expires: VIN#:
Work completed satisfactorily
Date
(INSPECTOR)
PLEASE FAX TO CITY OF SPOKANE VALLEY UPON COMPLETION (509)688-0037
Effective October 28, 2007
Page 1 of 1
P.\Community Development \ Forms \Building forms\Right of Way Permit App.doc
Spokane
„Valley®
y•r. s — -1° k-13.•
ForCity Use Only7�
PLUS Project Number CPit ,, '{ Ys
Project Address
(Via AnrAin 4
11703 E Sprague Ave Suite B-3 • Spokane Valley WA 99206
509.688,0036 • Fax: 509.688.0037 • permitcenter@spokanevatley.org .
•
As part of: our on-going commitment to customer service during the .review' process: of your project
application, we are providing you with.a TARGET DATE for, the initial technical application review. If fol.-
any
orany reason we cannot meet this date, we will.contact you with a revised target date.
Your application review TARGET DATE is .
The TARGET DATE -is the date we estimate your project application will have had its initial technical:
review. It is not the date for approval or permit issuance..
Tips for a Smoother Project Application Review
i Submit complete, accurate plans and documents.
Evtra time may be required for re -submittals as project application reviewers work'ar'muNiple'applications and it
nuay be several dans before they can look at your new or revised information.
•
i Designate a specific contact person to communicate with the City. .
While the person designated as the applicant's contact person with the:City can be changed, one individual with.tlne
expertise for dealing with reviewer connnents wou/d be'the best choice for the entire review process. •
i Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target dale, please feel free, to contact us if i'ou haven'/ beardfn om us'•
by your target date. Staff may contact you before the target date if the initial review is complete. By following this
procedure, you will save time and allow the reviewers to complete the work more expeditiously. ;
Steps in the Permit Process
1..Counter Complete. Your application has been accepted as counter Complete.' This means all of the required
documents, as indicated on your Pre -Application Checklist. have been submitted or- have_ been approved, for: deferred'.
submittal. This does not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a,quality check to make sure that the -application is reviewable'and free ,
from substantive flaws that would prevent technical staff from completing the technical review once'it fs started. 'When
this step is complete, your application will be• routed to the appropriate staff and remairi in their review'queue until it
comes up. for review.
3. Technical Compliance. Once an application is administratively complete, it is routed _to technical staff for compliance
review. Depending on the type of project, technical staff may include multiple reviewers. You should.be contacted by
phone, fax, email, or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application'' -is complete; including any subsequent re -
submittals, each reviewer will approve their section of the application and route it tothe Permit Center. When all sections
of the application are received, a Permit Specialist will process the application and, contact the person specified on your
application for permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by
the Permit Specialist at that time. '
WHITE—APPLICANT PINK—BUILDING FILE REV9/07
% •.1'.
SCITY®y al�
Valley®
ADMINISTRATIVE EXCEPTION
CHECKLIST & APPLICATION
SVMC 19.140
Community Development— Planning Division
11703 E Sprague Ave Suite 8-3 • Spokane Valley WA 99206
509.688.0197 • Fax: 509.688.0037 ♦ planning®spokanevalley.org
Prior to completing this form, please refer to Chapter 19.140 of the Spokane Valley Municipal Code
to see if your request qualifies for an Administrative Exception.
PART I — REQUIRED MATERIAL
❑ Completed Application Form
❑ If Applicant is not the Legal Owner, Include Written Authorization from the Owner
RECEIVED
Application Fee
Site Plan (which includes the following):
Submit one (1) 8 % inch by 11 inch copy with all of the following information: AUG c 0 2009
1. All dimensions scaled (e.g.: 1"= 50'). SPOKANE VALLEY
2. North arrow DEPARTMENT OF
3. Show actual property boundaries and dimensions. COMMUNITY DEVELOPMENT
4. Label and show location of existing buildings/structures, septic tanks, drainfields, wells or
other improvements showing dimensions and distance to property boundaries.
5. Label and show location of proposed buildings/structures (including exterior decks and
balconies) showing dimensions and distance to property boundaries.
PART II — APPLICATION INFORMATION
APPLICANT: \-\C<`rc—:\ 2.oc� C�a�j%
MAILING ADDRESS: J. \--1- C c C i
CITY: V(ThUV-C. (--,i.
STATE:\N_,S.\
ZIP: C\?\:-Lik.i.
PHONE:Ct. \c:\Z-k?j\ )k
FAX: \' _ck: ck
CELL: 9Z,-\'4, 1/4.1,
EMAIL:
""NOTE•IFAPPLICANTIS NOT THE LEGALOWNER. INCLUDEWRITTENAUTHORIZATION FROM OWNER**
LEGAL OWNER: CC -T-•1,-;
MAILING ADDRESS:
CITY:
STATE:
ZIP:
PHONE:
FAX:
CELL:
EMAIL:
TAX PARCEL No.: SSI32,3901
SITE ADDRESS: wyj\\
ZONING DESIGNATION:
COMPREHENSIVE PLAN CATEGORY:
ADMINISTRATIVE EXCEPTION CHECKLIST 8 APPLICATION
REVISED 01/08/09
Page 1 of 5
Spokane
.FM lleym
TYPE OF ADMINISTRATIVE EXCEPTION REQUESTED AND REASON FOR REQUEST:
'n-v.e.CJ \fir C�G •�J� d \ \'
APPROVAL CRITERIA
How DOES YOUR REQUEST MEET THE FOLLOWING CRITERIA?
19.140.020 Approval Criteria.
Criteria for approval or denial of applications shall be established by the director if it is shown that:
A. The administrative exception does not detract from the character and nature of the vicinity in
which it is proposed;
B. The administrative exception enhances or protects the character of the neighborhood or vicinity
by protecting natural features, historic sites, open space, or other resources;
C. The administrative exception does not interfere with or negatively impact the operations of
existing land uses and all legally permitted uses within the zoning district it occupies;
D. Granting the administrative exception does not constitute a threat to the public health, safety and
welfare within the City. (Ord. 07-015 § 4, 2007).
a C,
ADMINISTRATIVE EXCEPTION CHECKLIST & APPLICATION Page 2 of 5
REVISED 01/08/09
Spokane
0#Valley°
PART III - LEGAL OWNER SIGNATURE
(Signature of legal owner or representative as authorized by legal owner)
I, C , (print name) swear or affirm that the above responses are made
truthfully and to the best of my knowledge.
I further swear that I am the owner of record of the area proposed for the above -identified land use action,
or, if not the owner, attached herewith is written permission from the owner authorizing my actions on
his/her behalf.
Address:
Phone: vl\c5., \ S�
City: State: \5\A Zip: g>N.Z cmty
(Signature)
NOTARY
(For Part II above)
STATE OF WASHINGTON)
ss:
COUNTY OF SPOKANE )
SUBSCRIBED AND SWORN to before me this day of
NOTARY SEAL
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It")-.t°%0N �:tp��i, - �i My appointment expires:
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OF
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(Date)
200/
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NO ARY GNATURE
Notary Public in and f r the State of Washington
Residing at: (lam+
ADMINISTRATIVE EXCEPTION CHECKLIST & APPLICATION Page 3 of 5
REVISED 01/08/09
Sp"'Wane
FValley�
PART IV - DETERMINATION
File No: ADE -
19.140.020 Approval Criteria
Criteria for approval or denial of applications shall be established by the Director if it is shown
that:
A. The administrative exception does not detract from the character and nature of the vicinity in
which it is proposed;
B. The administrative exception enhances or protects the character of the neighborhood or
vicinity by protecting natural features, historic sites, open space, or other resources;
C. The administrative exception does not interfere with or negatively impact the operations of
existing land uses and all legally permitted uses within the zoning district it occupies;
D. Granting the administrative exception does not constitute a threat to the public health, safety
and welfare within the City (ord. 07-015§ 4, 2007).
The administrative request meets the following criteria as required under SVMC Section 19.140.020.
A, C;D
The Community Development-Directo a(proves denies this "Administrative Exemption" as conditioned
beloyy, for the propprty described in Pa nt to SVMC 19.140.
^'(3
This administrative exception is subject to the following conditions of approval:
1) This administrative decision shall apply'to the subject property indefinitely and may be transferred to
future property owners, hgirs.or any successor-in:interest to the property subject to the conditions of
approval contained herein. ti' 'J • .''y..
2) The applicant and property owner shall comply with all requirements and regulations of the Zoning
Code.
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3) The applicant shall comply with all applicable development regulations and stand rds1;1111`.1/4-.,.
1,1 oxitll
4) The applicant and property owner• shall comply with the following additional conditibns;3
n'Q .Oat..
ADMINISTRATIVE EXCEPTION CHECKLIST & APPLICATION Page 4 of 5
REVISED 01/08/09
Spokane
�valleym
This administrative exception is hereby approved this 3 t6 day of Al)�}, 200cl
Approved by: St f t �l,.l',Q,(, Title: C1111Iht G1u�tf �j �—D,itt �
PERMIT NUMBER: V .�E.- 04- �IrG11� v_l
PERMIT FEE: VO, ,
Under SVMC 17.90, any person aggrieved by this administrative determination has the right to appeal this
administrative decision to the City of Spokane Valley Hearing Examiner. An appeal must be filed by
submitting the appropriate appeal application together with the required fee to the Department of
Community Development Current Planning within fourteen (14) calendar days after the decision is issued.
Upon receipt of a complete appeal application, a public hearing will be scheduled. For information or
questions, please call the Planning Desk at (509) 688-0197.
STAFF USE ONLY
Date Submitted: R/2G, /zoo 9 Received by: 'O�J'"t Fee: .300, Go
PLUS Number: O OOZ7R8 File#:_42)g- - -09
ADMINISTRATIVE EXCEPTION CHECKLIST 8 APPLICATION Page 5 of 5
REVISED 01/08/09
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PLANNING PT. APPROVED
BY: d420-,61.04474/'
DATE: g/31 /2-009-
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