2005, 04-12 Permit App: 05001149 Safety Inspect Project Number: 05001149 Inv: 1 Application Date: 04/12/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SAFETY INSPECTION OF 11 X 14 ATTACHED Contact: ANDERSON,JARED&BARB
POTTING/STORAGE SHED Address: 1811 N SALMON RIVER LN
C-S-Z: SPOKANE VALLEY,WA 99016
Setbacks:Front N/A Left: N/ Right: 5 Rear: EX Phone: (509)922-1968
Group Name:
Site Information: Project Name:
Plat Key: 005835 Name: RIVERWALK 07TH ADD PUD District: East
Parcel Number: 55083.2111 Block: Lot:
SiteAddress: 1811 N SALMON RIVER LN Owner:Name: ANDERSON,JARED&BARB
Address: 1811 N SALMON RIVER LN
Location::CSV SPOKANE VALLEY,WA 99016
Zoning: UR-7 Urban Residential-7
Water District: 999 UNKNOWN Hold: ❑
Area: 1,101.00 Acres Width: 65 Depth: 133 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Review Released By: / j.
4
/ ..L
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
CHANGE OF USE/SAFETY INSP I SELECT $47.00
STATE SURCHARGE 1 SELECT $4.50
Permit Total Fees: $51.50
Operator: K_C Printed By: K_C Print Date: 04/12/2005
Prdject Number: 05001149 Inv: 1 Application Date: 04/12/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
OK TO ISSUE SEWER PERMITS PER ROGER 12/16/97
ALL PERMIT APPLICATIONS IN MISSION MEADOWS MHP MUST HAVE PLANNING
DIVISION REVIEW BY MICKI HARNOIS OR GREG MCCORRMICK
Payment Summary: : ::
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $51.50 $51.50 $0.00 $51.50
$51.50 $51.50 $0.00 $51.50
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: K C Printed By: K_C Print Date: 04/12/2005
-- BUILDING PERMIT APPLICATION WORKSHEET
' r�' . poKarte City of Spokane Valley Community Development Department
Building Division
Sprague 40,ValleY
11707 E. Sp g Avenue,nue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 180 0 I') .R:U« LI\J
Assessor's Tax Parcel Number(s):
Legal Description: n(�l�,1 �i 1 l 4.6 PERMIT DESCRIPTION: NIcc.\7. �h,UJ 1cc
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
''p) •
Owner: ,..\ast_ 41.6,A) 4--. c),\ ❑ Applicant: •
Phone: (10-91,1-1564i Fax: Phone: Fax:
Address: /Q,i, N SSI , -.J« LN Address:
c- oNoc tiVz.., V'1C\ 5'904
cifyi State Zip Code City State Zip Code
❑ Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License#: Contact:
Spokane Valley Bus. Liscense#: Contact:
•
N PERMIT/BUILDING INFORMATION I
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 2""FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
Inspector(s):
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 inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard#: Expires: VIN#:
Authorized Signature:
I
MAIN FLOOR SF: 987
SECOND FLOOR' SF: 0
DDRESS: Ln.
BASEMENT SF —
EGAL DESCRIPTION:
SF: 0
1811 N. Salmon River FINISHED 835
IDT: 1 1 BLOCK: 1
UNFINISHED SF:
PLAT: Riverwalk 7th Add.
ONTRACTORS' #: CONDRCI022MT GARAGE SF: 490
CALE: 1" = 20.0'
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