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2005, 08-26 Permit App: 05003020 AdditionProject Number: 05003020 Inv: I Application Date: 08/26/2005 Page 1 oft THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 19 X 21 MASTER BEDROOM ADDITION Setbacks: Front 32 Left: 18 Right: 18 Rear: 50 Site hiformatioi7: Plat Key: 000000 Name: RANGE Parcel Number: 45213.9169 Block: SiteAddress: 1219 S PIERCE RD Contact: SMART CONCEPTS INC Address: PO BOX 1178 C - S - Z: MEAD, WA 99021 Phone: (509) 927-0130 Group Name: Project Name: District: Sout Lot: Owner: Name: ROSENBERG, MIKE Address: 1219 S PIERCE RD Location:: CSV SPOKANE VALLEY, WA 99206 Zoning: B-1 Neighborhood Business Water District: Hold: ❑ Area: .36 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information :; .... , F.,.... �,..,..., . , Review Site Plan Review Originally Released: 08/26/2005 By: cjjanssen Plan Review Released B Sewer Review Permits: Originally Released: 08/25/2005 By: TMELBOU Released By: SEWER PERMIT #99004433 Originally Released: 08/26/2005 By: cjjanssen Operator: CJJ Printed By: CJJ Print Date: 08/26/2005 Project Number: 05003020 Inv: I Application Date: 08/26/2005 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Contractor: SMART CONCEPTS CONST LLC Address: PO BOX 1178 MEAD, WA 99021 Building Permit Firm: SMART CONCEPTS CONST LLC Phone: (509) 927-0130 Total Project: SSC Ft Valuation 96 $1,440.00 444 $33,157.92 540 $34,597.92 Fee Amount $492.25 $4.50 $196.90 Permit Total Fees: $693.65 Notes Payment Summary:.y�N;, Permit Type Fee Amount Invoice Amount Amount Paid Amount Owine Building Permit $693.65 $693.65 $0.00 $693.65 $693.65 $693.65 $0.00 $693.65 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: 08/26/2005 This Application: Description Grp Tvve Notes Sa Ft Valuation DECK R-3 VB 96 $1,440.00 RES ADD R-3 VB 444 $33,157.92 Totals: 540 $34,597.92 Item Description Units Unit Desc RESIDENTIAL PERMIT FEE 1 SELECT STATE SURCHARGE 1 SELECT RESIDENTIAL PLAN REVIEW 1 SELECT Total Project: SSC Ft Valuation 96 $1,440.00 444 $33,157.92 540 $34,597.92 Fee Amount $492.25 $4.50 $196.90 Permit Total Fees: $693.65 Notes Payment Summary:.y�N;, Permit Type Fee Amount Invoice Amount Amount Paid Amount Owine Building Permit $693.65 $693.65 $0.00 $693.65 $693.65 $693.65 $0.00 $693.65 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: 08/26/2005 - (� BUILDING PLKMA i F�f'I� LIUAI Ii..IN ''V%1L) f'L5t1t=t:I C,ty of Spokane Ua,','ey Community Development Depa; tmer-�f 13P&W Building Division 11707 E. Sprague Avenue, Suite 105 Spokane valley, WA 99203 Phone. (509) 653-0036, Fax: (509) 633-0037 j j `FE'E'L UIRED SITE INFORMATION Street Address: (�iI eICGC Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: YV A Z za Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other G OWNER/APPLICANT INFORMATION ❑ _Owner. Phone:Fax: Address: Pt ce- r . City State Zip Code ❑ Contractor: �JII LLr=L C b IQ El Phone: is 7o,ax: shy 5 a71& , Address: -)V /(7y city State Zip�Cade Applicant: Phone: Fax: Address: City state Zip Code Architect: Phone: Fax: Address: City State Zip Code WA State Contractor License #: S 1l714r 1(' C�'Io 3,i✓ZContact: Spokane Valley Bus. Liscense #: Contact: PERMITIBUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: / 4 OF STORIES: I 1 ' k 2-1 x712 MAIN FLOOR TO SQ. FTG: FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: `f- •-t '- FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECKlCOV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: �t lc( # OF BEDROOMS: t TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC i SYSTEM?'U' t' �2 Nidth: Manufacturer: Previous Address: Proposed Use: _ =ire Sprinkler. Tent: Jaluation: MANUFACTURED HOME Length: Year RELOCATION FIRE SAFETY # of Heads: Fire Alarm: Fireworks Display: Blasting: Above/Underground Storage Tank Size: Pit Set: Paint Booth: Date/Time: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Tans Examiner. Phone: Fax: kddress: city state nspector. Phone: Fax: kddress: city state —1 BOLTING =irm Name: nspector(s): SPECIAL INSPECTIONS ❑ CONCRETE ❑ REINFORCEMENT Phone: Fax: Zip Zip ❑ WELDING )ISCLAIMER -he permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a Welling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the )roperty owner. 3) The signatory is the property owner or has permission to represent the property owner in this ransaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Zeferenced codes are available for review at the City of Spokane Valley Pefrfi-ft Center. 5) This City of Spokane Valley 'ermit is not a permit or approval for any violation of federal, state or local aws, codes or ordinances. )wnership of resulting development rights granted by any issued permit `nine to the pr perry 'riot Name Signature(__A Method of Payment: (Faxed pen -nit applications will only be accepted with major bankcard) Cash ❑ Check ❑ Mastercard ISA >ankcard #: authorized Signature: Expires: 1T J13 ❑ Other