2002, 02-11 Permit App: 02000798 AdditionProject Number: 02000798
Inv: 1
- Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/11/02
Project Information:
Permit Use: 22 X 11 BEDROOM ADD W/REMODEL OF Contact: ALLERT CONSTRUCTION
Address: 208 E COZA DR
C - S - Z: SPOKANE WA 99208
Setbacks: Front NA Left: 15 Right: NA Rear: 40+ Phone: (509) 487-0305
Group Name:
Site Information: Project Name:
Plat Key: 001865 Name: ORCHARD AVENUE ADD(TR.1-228)
Parcel Number: 45063.2320 Block:
EXISTING TO BATHRM & LAUNDRY
Page 1 of 3
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District: H
SiteAddress: 3722 N PARK RD
SPOKANE, WA 99212
Location:: SPO
Zoning: UR -3.5
Water District:
Area: 0 Sq Ft
Nbr of Bldgs: 0
Review Information:
Review
Site Plan Review
Plan Review
Septic System Review
Scv
for
Permits:
_sv :.ilocj
Urban Residential 3.5
Lot:
Owner: Name:
Address:
RUSSELL, RAY
3722 N PARK RD
SPOKANE, WA 99212
Hold: ❑
Width: 100 Depth: 190 Right Of Way (ft): 0
Nbr of Dwellings: 1
Released By: t• 2j" *
Released By: _ WLauti . • , ' 1!• tZ,
Released By:
Operator: CKF Printed By: CKF
Print Date:
2/11/02
Project Number: 02000798 Inv: 1
Application
THIS IS NOT A' PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/11/02 Page 2 of 3
Building Permit
Contractor: ALLERT CONSTRUCTION INC Firm: TERRY ALLERT CONSTRUCTION
Address: 208 E COZZA DR Phone: (509) 487-0305
SPOKANE, WA 99208
Const Category: Addition
Building Characteristics
Group: R-3 Type: VN
Nbr Of Dwellings: 1 Occupant Load: Building Height: 16 Stories: 1
Bldg W x D: 22 x 11 Building Sq Ft: 262 Sprinklers: 0
Req Parking: Handicap Parking: Critical Materials: 0
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 262 $16,244.00 262 $16,244.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Totals: 262 $16,244.00 262 $16,244.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$250.50
$4.50
$55.11
$310.11
Contractor: ALLERT CONSTRUCTION INC Firm: TERRY ALLERT CONSTRUCTION
Address: 208 E COZZA DR Phone: (509) 487-0305
SPOKANE, WA 99208
Item Description
DUCT SYSTEMS
VENTILATING FANS
CLOTHES DRYER
Units Unit Desc
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$10.00
$20.00
$10.00
$40.00
Plumbing Permit
Contractor: COUGAR MECHANICAL INC Firm: COUGAR MECHANICAL INC
Address: E 3838 JOSEPH #A Phone: (509) 484-6420
SPOKANE, WA 99217
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
CLOTHES WASHER
WATER SOFTENER
WATER PIPING - DWV
Units Unit Desc
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: CKF Printed By: CKF
Permit Total Fees:
Fee Amount
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$42.00
Print Date: 2/11/02
Project Number: 02000798 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/11/02 Page 3 of 3
Notes - m4
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$310.11 $310.11 $0.00 $310.11
$40.00 $40.00 $0.00 $40.00
$42.00 $42.00 $0.00 $42.00
$392.11 $392.11 $0.00 $392.11
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 contrued 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: CKF Printed By: CKF
Print Date: 2/11/02
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PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: f•\1
Assessor's Tax Parcel Number(s): 46—
C76,�
Legal Description:,r`�� �
( )AiP4) 14ti1 e LI, 4/0 0-6- of `- ALL- T /
2-7-- s as l a-7
Project Description: A : -L o+-�
.J3uilding Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
El Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear.
Left: Right:
School District
Fire District:
Zoning.
OWNER/APPLICANT INFORMATION
Jedieute who should be , ontacted re2ardin„ //x project
171• Owner: Phone: tb..(1" �� sp1.
KL g , e 1 / I ax:
El Applicant:
Phone:
Fax:
Mailing Address:
,, Poi,
Mailing Address:
Dimensions�f
s)-3 /&,I K /1 6
CM, State, Zip
City, State, Zip
Finished basement sq. ft.
on/trcHx
L
Phone /Jb2._0 C,---
—70
du ,,I
ft L Fax '/ e7-4/5-3 3
❑ Architect, I :nl,>inecr
I hone
I Fax
Mailingaddress -n
5 h �/
Mailing address
City, State Zip
f0 I`, r, . - cia.og
City, State /4i
\\ A State (tntractor license # J
ALL Eeg- t° ro 3 y"4 `{
Contact name:
PROTECT INFORMATION
Building Information
Building height ujpeak
/Z
# of stories
1
Main floor 'y. ft.
AQr.7)t —fes cZ
Unfinished basement sq. ft.
Dimensions�f
s)-3 /&,I K /1 6
Total habitable space
2" `I floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
beck sq. ft.
Cost of project /,
I leat source (electric, 2s, etc)
Manufactured Home
Sign
Width:
Length:
What is the square footage of the sign
face? ,
Mow high is the sign?
Year:
Make:
# of signs
Area of existing signs
Fireworks display
.Arc critical or hazardous materials used or stored on site?
O .,i
Ycs No
Address
Proposed use
Relocation
Fire Safety
Firm Name
What is the current use of this property?
/'C .2 i C8.1/ c__Q-•
Previous address
Will the site be served by a septic system? J53 Yes O No
Paint booth
lire Sprinkler
Tent
Fire Alarm
Fireworks display
.Arc critical or hazardous materials used or stored on site?
O .,i
Ycs No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
/'C .2 i C8.1/ c__Q-•
Phone
Will the site be served by a septic system? J53 Yes O No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
O Ycs No
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( %) O Ycs 0` No
.Arc critical or hazardous materials used or stored on site?
O .,i
Ycs No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? C Yes O No
Ifyes, ident� on site plan
What is the current property size? `' f
(square feet or acres) 7S / X ( gni
Is any part of the property within 250 feet of a shoreline?
Ifyes, identt on site plan O Yes XNo
What is the current use of this property?
/'C .2 i C8.1/ c__Q-•
Is your property in a designated wildlife habitat arca?
O Don't know O Ycs -No
Will the site be served by a septic system? J53 Yes O No
1s any part of the property within a 100 yr flood plain?
Ifyes, idents on site plan
O Maybe O Don't know O Ycs ti No
.1re or will there be wells located on the property?
I Eyes, identifi on the site plan O Ycs 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identify on site plan O Ycs $- No
Is there evidence of fill or excavation on the property?
O Ycs No
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( %) O Ycs 0` No
.Arc critical or hazardous materials used or stored on site?
O .,i
Ycs No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? O Yes O No
Is the property inside the ASA? O Yes O No
O Yes O No
Is public water available to the site? O Yes O No
Is the property inside the PSSA? O Yes O No
Is the property located within 1000 feet of a Natural Resource Arca?
O Yes O No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ c:\SI1 do lI CK 0 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
1) ATE:
:
IFNPIRI?S:
B:ANKC:ARI) NUMBI?R:
AUI'Ii0RI'/,I?I) SIGN:ATURI?:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00 PLEASE
\LAKE. CHECKS P: AYAI31:F. TO SPOKANE:
COUNTY PIIR\IIT CENTER
15
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