2012, 08-09 Permit App: BLD-2012-0923 Residencelley.
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@ saokanevalley.orq +P to I c c i
RESIDENTIAL CONSTRUCTION P RMIT APPL ' ION
NEW CONSTRUCTION ADDITION/REMODEL
el DECK 11 OTHER
SITE ADDRESS:
ASSESSORS PARCEL NO.:
kl
ACCESSORY BUILDING
C `>V PE , ER•
LE DESCRXPTION:
BUILDING OWNER NAME:
NAME: I/ I4 140 M Oa. ✓ VCT 0
ADDRESS: '2 k7 NI E iiNidge4,rrio<o
44
CITY: fDF--�N� �t ST ' ki
PHONE J 1�-1�c7 F 1! c/ 1
loo
1-6
CTOR NAM
ZIP: ell gc-,&,
CELI.��J00 I1 -1oc'
UI' 15 CELL(at) Z I L'�i 7o(%
MAI G ADORE, r �1 V 127.
0 . \ A UJ -r' STATE:
kin
vvv t FA4t )' L - c2[95
i1 -C 1cOv
CTOR LICENSE 1,601 L..* $'I L.- ' EXPIRES: i 'ZL74 Cm►
DESCRIBE THE SCOPE OF WORK I DETAIL A
CELL:
ZIP: 1g
j---(d'j�3c7
BUSINESS LICENSE NO.:
ATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
Height to Peak: b(
Dimensions: 1
ir,1
No. of Stories: 1
Total Habitable, lb
Space:
MaifloIr SQ
�/ �j
Upper Floor
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:Deck/Covered
I S l
Patio SQ
FT: 47
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type: 1,160D
Heat Source:4.A.,..Sewer
r Septic: ,
TOTAL COST OF PROJECT:
The permitted verifies, acknowledges and agrees by their signa ure hat: 1) if this permit is for construction 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) The 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 r y be required to be s e matted and subsequently approved before this application can be processed.
ffective October 2 : , 200
y_
Page 1 of 2
P:\Community Develop ent\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
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Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcentertwalspokaneva Ilev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
ES ACCESSORY BUILDING
.111 NEW CONSTRUCTION fa ADDITION/REMODEL
DECK// OTHER
SITE ADDRESS: 61 M I4 H is4F, ki
ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION: Imo-( l 0I.K 2 I301.14 14g»1•
BUILDING OWNER NAME:
NAME: LN 1,, 042'vr 6 ( 0421/1,6
ADDRESS: !/4O 4, I��IJ� r' � '7L)a *
Cmr:
STATE: LI
PHONE: !� ( IOC FAX: 6 Cr� '0115
CONTACT NAME: 166.4U4 HLoDe.j. 1
CELL:
ZIP:
.I1 - 691067
PHONE: j a- .60160 FAX: 1n -47115
CONTRACTOR NAME: ri(fva0004 SME, LIZ-
MAILING
I Z
MAILING ADDRESS: , J u I J vii"L 60. Z' h V °
CITY: v/ LYvetg, INIA061" STATE:�Ac,
PHONE: (' 11' `�✓ FAX: q!/i!�' 0 I9d
CELL:
CELL:
ZIP: 1 l tav
1 -c - 0a
CONTRACTOR LICENSE No.:KEA/ M+ii 1,14 EXPIRES: 1 (�CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCO_ PEWF WfV9I0N4DCNLL AND
'zINDr, ICATF6SE9 NPROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
APPLICABLE
Height to Pea I:
.„6011
�
Di erysio9fi: I +�
�? --64,X Or_2
No. of Stories:
Total Habitable I2� (t}
Space:
Main Floor SQ It5v
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
ii,+iD til
Deck/Covered P o SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property: ..
No. of Bedrooms: ,77
Construction Type: Wee P
Heat Source: 4f4
Sewer r Septic:
TOTAL COST OF PROJECT: $ 76 000
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction 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) The 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.
Effective October 28, 2007 Page 1 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
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PLANNING DEPT. APPROVED
BY: '/y'/A LLr
V 0
DATE: 6, 69/202-
)79-14
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SPOKANE COUNTY BUILDING AND PLANA
PERMIT
Application Number: SW -12001541
Permit Issued Date:
06/13/2012
Expiration Date:
Project Description:
Project Name:
Permit Type:
SEWER CONNECTION
ROTH ADDITION
SEWER
Primary Contact:
Applicant:
Address:
Phone:
Email:
FOLSOM EXCAVATING
FOLSOM EXCAVATING
16701 E VALLEYWAY
VERADALE, WA 99037
(509)979-6002
SITE INFORMATION:
Site Address:
Parcel Number:
Subdivision:
Assessor's Description:
Inspection Area:
Zoning:
5124 N MAYHEW RD
46344.1702
PLAT NO 4 OF WEST
FARMS IRRIGATED
TRACTS
ROTH ADDITION, PHASE 1: LOT 2 BLK 2
6055341 - PTN SE1/4 OF 34-26-44)
(AFN
Owner:
Address:
Phone:
Email:
LOTS N LAND
210 N UNIVERSITY RD STE 300
SPOKANE VALLEY, WA 99206
Water District: Trentwood Fire District: Spokane Valley Fire
Irrigation District #3
Land Area: 0.191 acres / 8320 sqft
CONTRACTOR INFORMATION:
General Contractor
FOLSOE1994DO
FOLSOM EXCAVATING INC
16701 E VALLEYWAY AVE
VERADALE, WA 99037
509-891-1232
DETAILS:
Class
Type
Quantity Unit Charge Value
SEWER SEWER CONNECTION
FEE DETAIL:
Processing - Utilities
Utilities Permit
1 $125.00 $125.00
Total Fee:
$125.00
$25.94
$125.00
$150.94
CONDITIONS:
FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO COVER.
ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL INSPECTION FEES
APPLY AFTER 30 MINUTES.
Date Printed: 06/13/2012 08:11:36
Printed by: IIS APPPOOL\ASP.NET v4.0
•
SPOKANE COUNTY BUILDING AND PLANNING
PERMIT
Permit Issued Date:
Application Number: SW -12001541 06/13/2012
Expiration Date:
INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND MAY BE REQUIRED
TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE ELEVATION AND POSITION OF
SEWER STUB PRIOR TO ANY OTHER EXCAVATION.
SEWER STUBS AND DRY SIDE SEWERS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY HAVE
ACCEPTABLE GRADE AND ARE CLEAR AND UNOBSTRUCTED. SEWER LINES SHOULD BE CONSTRUCTED TO ALLOW FOR
GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE.
THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME. BOTH STATE
LAW RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO OWNERS OF
UNDERGROUND FACILITIES.
Date Printed: 06/13/2012 08:11:36 Printed by: IIS APPPOOL\ASP.NET v4.0
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(„'.ornmunity Development Departrnent ,_.
iiiii..Coiti:,ie
(Stagi lio.e. Only)
11703 East Sprague Avenue, Suite B-3
I
Spokane Valley, WA 99206 PERMIT NUMBER:
Tel: (509) 683-0036
Fax: (509) 683-0037 PERrirr PEE: _,Ir
DeriniLcen[c-i-,dspokatievalley.orq
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QC Check
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Project Contact 'iorrnation:
Penrtirc_k.
Name:
Email:
VERIFIED/INITIALS
LJ
111
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VERIFIED/INITIALS
El
Relationship to Project:
Phone:
Fax:
VERIFIEDRNITIALS
El
I
9- 717g
Architect LI Engineer 1 Contractor OyypeljApplicant Li Other Design
Pi'bregrintan
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DATE STAMP:
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Effective October 28, 2007
Page 1 of 1
P:\Community Development\11 Forms\A. Building\Building forms\Permit Center Project Transmitta1.1.doc