2005, 08-18 Permit App: 05002994 Tear Off, Repair Roof Project Number: 05002994 Inv: 1 Application Date: 08/18/2005 Page 1 of 2
THIS ISNOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: TEAR OFF&RE ROOF/MINOR FRAMING Contact: JADDA BEASON
REPAIRS FROM TREE DAMAGE Address: 3928 E MARIETTA
C-S-Z: SPOKANE,WA 99217
Setbacks:Front Left: Right: Rear: Phone: (509)863-2755
Group Name:
Site Information: Project Name:
gvestaiww.matmgsmunsoltwerea:. , .o. mea, :,, .weamemmanakovam
Plat Key: 001841 Name: OPPORTUNITY TERRACE District: F
Parcel Number: 45272.0439 Block: Lot:
SiteAddress: 12711 E SALTESE RD Owner:Name: HERDRICH,NORMAN
Address: 12711 E SALTESE RD
Location::CSV SPOKANE,WA 99216
Zoning: AGSUB
Water District: Hold: ❑
Area: .00 Acres Width: 105 Depth: 130 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information: 1 .
Review
Plan Review Released By: �
i
Building Permit
Contractor: BEASON GENERAL Firm: BEASON GENERAL CONTRACTI
Address: 3928 E MARIETTA Phone: (509)863-2755
SPOKANE,WA 99217
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VB REPAIR 0 $6,403.75 0 $6,403.75
TREE
DAMAGE
Totals: 0 $6,403.75 0 $6,403.75
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $139.25
STATE SURCHARGE 1 SELECT $4.50
Permit Total Fees: $143.75
Operator: CJJ Printed By: KJK Print Date: 08/18/2005
Project Number: 05002994 Inv: 1 Application Date: 08/18/2005 Page 2 of 2
THIS IS"NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes :TM.. ..,.: v, n4_ ,a .., :;1011%.,1. '7z
Payment SummorV: 44, 4= :, cam .7sEgigra . IssonswzmAvmattsma
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $143.75 $143.75 $0.00 $143.75
$143.75 $143.75 $0.00 $143.75
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: KJK Print Date: 08/18/2005
0,1: _ BUILDING PERMIT APPLICATION WORKSHEET
,. City of Spokane Valley Community Development Department
CG, Building Division
OS .2 l q� 11707 E. Sprague Avenue, Suite 106
T- valley Spokane Valley, WA 99206
yr
- Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 12-711 E. Sa-Mc 5e Ave.
Assessor's Tax Parcel Number(s):
Legal Description: lC t--EE os6_,
PERMIT DESCRIPTION: /eg.- o e -ie.& i i iviieDA&fn.)
aM;;5 R. ;g4.
2 Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner. AiDa4At It S lie //eGQre-A ❑ Applicant:-i AVDA
Phone:.99 sg9 at*Fax: Phone:5 941343:zax:
Address: / re. e ddre s: 39'ZE. /4",-/e
-fl(
e eRA,7e ?i7
Ci State Vocil4'
CiState Zip Code
❑ Contractor: 8Gi���❑ Architect:
Phone:.0,44,3.2:755Fax: 3 Phone: Fax:
Address: 3, i‘ 5. /1a...e-fta. Address:
549;fr.e.ote tate Zip Code City State Zip Code
• License #: Sv S- C Contact: �} . /1
WA State Contractor �� �G �'b�
Spokane Valley Bus. Liscense #: (.D a `x`71 /5/ Contact:
PERMIT/BUILDING INFORMATION
HEIG O PEAK: DIMENSIONS: #OF STORIES:
/ M49, 33s .5--se—
MAIN FLOOR TO SQ. FTG: 21'4"FLOOR SQ. FTG: UNFIN BASEMENTSQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ.FTG: DECK/COV. PATIO SQ. FTG:
.5-->e Z5
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
OST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
(a 9 03, 7S' SYSTEM?
MANUFACTURED HOME
tVidth: Length: •''.P.ac ' Pit Set:
Manufacturer.
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
=ire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
rent: Fireworks Display: Blasting: Date/Time:
Jaluation: Abbve/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
kddress:
City State Zip
nspector. Phone: Fax:
address:
City State Zip
SPECIAL INSPECTIONS
BOLTING (l CONCRETE ❑ REINFORCEMENT ❑ WELDING
.irm Name: Phone: Fax:
nspector(s):
)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 Permit Center. 5) This City of Spokane Valley
'ermit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
)wnership of resulting development rights granted byy any issued permit inure to the' property owner.
'rint Name -J 411)A ` (j L SdN Signature —t'/th
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
] Cash -Check ❑ Mastercard ❑ VISA ❑ Other
Iankcard#: Expires: VIN#:
uthorized Signature: Jo, / �_/