2002, 05-09 Permit App: 02003521 Bathroom Project Number: 02003521 Inv: 1 di Application Date: 5/9/2002 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: BATHROOM IN BASEMENT Contact: EAGLE MOUNTAIN
Address: 204 S KOREN
C- S -Z: SPOKANE,WA 99212
Setbacks: Front Left: Right: Rear: Phone: (509)534-3934
Group Name:
Site Information: Project Name:
Plat Key: 000000 Name: UNKNOWN District: F
Parcel Number: 45084.0471 Block: Lot:
SiteAddress: 1823 N RAYMOND RD Owner: Name: BOLES,KENNETH M & BARBAR
SPOKANE,WA USA 00000 Address: 1823 N RAYMOND RD
Location:: SPO SPOKANE,WA 99206-3937
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 10,812 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Plan Review Releaged
Permits:
Operator: RMB Printed By: RMB Print Date: 5/9/2002
Project Number: 02003521 Inv: I Application Date: 5/9/2002 Page 2 of 3
THIS IS NOTA PERMIT
Penalties will be assessed for commicing work without a permit
Building Permit
Contractor: EAGLE MOUNTAIN Firm: LARRY HAIGHT/EAGLE MNTN C
Address: 204 S KOREN ST Phone: (509)534-3934
SPOKANE,WA 99212
Building Characteristics
Const Category: Remodel Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers:
Req Parking: Handicap Parking: Critical Materials: El
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN FINISH 0 $2,500.00 0 $2,500.00
BATHROO
M
Totals: 0 $2,500.00 0 $2,500.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $75.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $16.61
Permit Total Fees: $96.61
Mechanical Permit
Contractor: EAGLE MOUNTAIN Firm: LARRY HAIGHT/EAGLE MNTN C
Address: 204 S KOREN ST Phone: (509)534-3934
SPOKANE,WA 99212
Item Description Units Unit Desc Fee Amount
VENTILATING FANS 1 NUMBER OF $10.00
PROCESSING FEE I Y OR BLANK $25.00
Permit Total Fees: $35.00
Plumbing Permit
Contractor: EAGLE MOUNTAIN Firm: LARRY HAIGHT/EAGLE MNTN C
Address: 204 S KOREN ST Phone: (509)534-3934
SPOKANE,WA 99212
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 1 NUMBER OF $6.00
SINKS I NUMBER OF $6.00
SHOWERS I NUMBER OF $6.00
WATER PIPING-DWV 1 NUMBER OF $6.00
MINIMUM FEE ADJUSTMENT 1 Select $11.00
Permit Total Fees: $35.00
Operator: RMB Printed By: RMB Print Date: 5/9/2002
Project Number: 02003521 Inv: 1 Application Date: 5/9/2002 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $96.61 $96.61 $0.00 $96.61
Mechanical Permit $35.00 $35.00 $0.00 $35.00
Plumbing Permit $35.00 $35.00 $0.00 $35.00
$166.61 $166.61 $0.00 $166.61
Disclaimer:
Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information
contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not he contrued to he a permit for,or an approval of,any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: RMB Printed By: RMB Print Date: 5/9/2002
•
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ii4ci PROJRCT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
SPoxN CoINFY
SPECIFIC SITE INFORMATION
Street Address: 4023 f }}t 0 ei
r)
Assessor's Tax Parcel Number(s): 4+6, r
19
.01
Legal Description:
Project Description: Ifrl)L 3 r ozoom IA) ff/44-em clyurr SG ca, A t.-
P1 Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
El Relocation ❑ Sign ❑ Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Pprveyor Road width Setbacks..
Front Rear.
School District Fire District Zoning
Left: Right
OWNER/APPLICANT INFORMATION
0 Indicate arho should be contacted n„ardini this project
❑ Owner: Phone: ❑lLY.JLApplicant:caanApplicant: �y� Phone: 34/".._,/W 50,
th,. J ILA_ JG...c Fax: L�)j+c.�.. Nato 7 ' j Fax: 5—$ -Zoe 0 9
Mailing Address: Mailing Address:
1g13 /J Qvvtad Q ago / S kloge ,i
City,State,Zip City,State,Zip
Sp;44-44.0;; uJk 9 2oi� L'r .t � (Jr$ 9 9 Li 2.
CIContractor Phone Phone
�+ /� ❑ Architect/I:iginecr
9l yrt,G`'"'` t S ATPL4 J r Fax Fax
Mailing address Mailing address
City,State Zip City,State lip
WA State Contractor license# Contact name
AL`
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sel.ft.
Dimensions "Total habitable space 2"‘l floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project I feat source(electric,gas,etc.)
Manufactured Home • Sign
Width: Length: What is the square footage of the sign I low high is the sign?
!face?
1
Year: Make: #of sigrTs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone ? Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding 0 Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes 0 No What is the current property size?
If yes,identj on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
Ifyes,identifi,on site plan O Yes 0 No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes O No
O Don't know O Yes O No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identib,on site plan Ifyes,identify on the site plan 0 Yes 0 No
0 Maybe O Don't know O Yes 0 No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
Ijyes,identify on site plan 0 Yes 0 No 0 Yes 0 No
Are there slopes greater than 30°'o on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
/°%) 0 Yes 0 No 0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No
0Yes CI No
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
D Yes O No
Date Rerun ed. Sia If Representaine..
METHOD OF PAYMENT
SUBTOTAL
VISA
❑ CASA ❑ a Il':ch 0 0 ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D VI'I:: FAH RI
TOTAL FEE
13.1NI t.ARD NVNIBI'.R: MINIMUM PERMIT FEE IS$35.AOPLF_ASE
MAKE CHECKS PAYABLE TO SPOKANE
1UI'1IDRI'ZIEDSIGN.Al1 RI'.: COUNTY PERMIT CENTER