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2004, 05-19 Permit: BLD-04-04392 Addition, RemodelSpokane 4 \ii11ey 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: RESIDENTIAL ADDITION/REMODEL PERMIT 17811 E MONTGOMERY OTIS ORCHARDS WA 99027 2 STORY ADDITION - LIVING, KITCHEN & GARAGE W/REMODEL OF EXISTING HOUSE - OWNER CONTRACTOR JOE & SHARI BURNS JOE & SHARI BURNS 17811 E MONTGOMERY OTIS ORCHARDS, WA 99027 Lot: Bik: Parcel No: Phone: (509) 922-0117 Phone: Lic No: Permit #: Applied: Issued: Expires: BLD -04-04392 Zoning: 05/19/2004 05/19/2004 11/15/2004 General Information: VALUATION REROOF BUILDING HEIGHT TO PEAK DIMENSIONS COST OF PROJECT # OF STORIES # OF BEDROOMS FRONT SETBACK REAR SETBACK LEFT SETBACK RIGHT SETBACK OCCUPANCY GROUP CONSTRUCTION TYPE STRUCTURES ON PROPERTY CURRENT PROPERTY SIZE CURRENT PROPERTY USE SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS TUBS SHOWERS (PER TRAP) SINKS DISHWASHER CLOTHES WASHER WATER PIPING/DRAIN-IN WASTE FUEL BURNING APPL <= 100,000 DRYER FUEL BURNING WATER HEATER GAS PIPING (ea. OUTLET) AIR CONDITIONER 3 - 15 TON 97916 N 24-2 46 X 40 30000.00 2 3 40 145 14 10 r-3 5-n 2 70 X 225 RESIDENCE yes no 3 3 1 5 1 1 1 4 1 1 6 1 Fees: PLAN CHECK FEE BASIC PERMIT FEE WSBCC SURCHARGE TOILETS TUBS SHOWERS SINKS DISHWASHER CLOTHES WASHER WATER PIPING/DRAIN-IN WASTE FUEL BURNING APPL <= 100,000 DRYER FUEL BURNING WATER HEATER GAS PIPING AIR CONDITIONER 3 - 15 TON Total Calculated: Deposits/Receipts: Total Due: 391.90 979.75 4.50 18.00 18.00 6.00 30.00 6.00 6.00 6.00 60.00 10.00 10.00 6.00 20.00 1,572.15 1,572.15 0.00 THIS IS NOT A RECEIPT SpolC1TY LIF ��► ane ,,,,,•'�Ualley RESIDENTIAL ADDITION/REMODEL PERMIT 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Permit #: BLD -04-04392 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 development rights granted by any issued permit 1 r to the property owner. Print Name Staff Initials Sig Lure THIS IS NOT A RECEIPT Date