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2003, 05-16 Permit App: 03003421 Addition P oject Number: 03003421 Inv: 1 Application Date: 5/16/2003 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: UNHEATED HOBBY ROOM ADDITION TO Contact: DASSOW,DARIN RESIDENCE Address: 15417 E SALTESE C- S-Z: VERADALE,WA 99037 Setbacks: Front 32.5 Left: EX Right: 5 Rear: 20+ Phone: (509)922-3405 Group Name: Site Information: Project Name: Plat Key: 005636 Name: CELTIC ADD District: F Parcel Number: 45264.2602 Block: Lot: SiteAddress: 15417 E SALTESE RD Owner:Name: DASSOW,DARIN VERADALE,WA USA 99037 Address: 15417 E SALTESE LocationVER VERADALE.WA 99037 Zoning: UR Urban Reserve Water District: 010 VERA Hold: Area: 1,353.00 Acres Width: 0 Depth: 0 Right Of Way(ft): 45 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Released By: C `t r C r �7C477,6) Plan Review Released By J47c2 4-2 Permits: Operator: RMB Printed By: RMB Print Date: 5/16/2003 Project Number: 03003421 Inv: 1 Application Date: 5/16/2003 Page 2,of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: OWNER Firm: OWNER Phone: This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation STORAGE U-1 VN 572 $6,864.00 572 $6,864.00 Totals: 572 $6,864.00 572 $6,864.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $125.50 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $27.61 Permit Total Fees: $157.61 Notes: OK TO ISSUE SEWER PERMIT PER GENE REPP 2/17/98 CKF Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $157.61 $157.61 $0.00 $157.61 $157.61 $157.61 $0.00 $157.61 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 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: RMB Printed By: RMB Print Date: 5/16/2003 • f, i lk il PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 SPOKANE COWY 509-477-3675 SPECIFIC SITE INFORMATION t Street Address: y i / 7 `S4G7j Assessor's Tax Parcel Number(s): .4 5 2& '. 2&C, 2 Legal Description: 4r .7 - 2 .c,7'C ,4ii9, 7iCr✓ c/Z. Z 1 Project Description: /�L'/30 f _L--'/->IO , ,r4.0 / 7-/z A/ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit ❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other e _ at -§ru 1?;oa dtl% �3 72 -' Y � R zt� +. K^"- .. r ` -"^- . ...-',;:;•: ,'-':. & ?.irt.T t- s — . Ya 0 3 Fbf' a 3 H - Ni t ' 'ate' .,," s,iSC6I3cG - ° AjPal �, zi i3 ` " i � `K a rettSm*m* - P!ve:,--.-R.425 K -7, �z . e fila t+ .,,," rrjF1 - r14Z**. . , 4 r.: OWNER/APPLICANT INFORMATION El Indicate who should be contacted regarding this project `2I Owner: Phone: '7'L Z - 3 9G-:5— ❑ Applicant Phone: ,.2,/)/2/ ,rSS0a: Fax: /?2 - OHO -Aal E /95 (,)LC>.lJ- /'L Fax: MailingJAddress: Mailing Address: 5-,y�7 ,/-/C.7-E S /t /i / City,State,Zip City,State,Zip 0e/c'%4`ef [to, ,f---7)s/-zcrA-' " , ❑ Contractor Phone ❑ Architect/Engineer Phone Fax --- Fax Mailing address Mailing address City,State Zip City,State Zip WA State Contractor license# Contact name: PROJECT INFORMATION is. 'y' :t � a-- a.'- _ .-.' ' . , - -- � " s- .-----.--',- -�.,. 'ate ' 6 " --% � � e �x6. 0Il � � � `� �x x _h. . . _ . _ ' � - . s �- . "� _;.,f� _ ._ k _ , -,._ . ,f. Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft. C t, e" -S7Z .5.7 /j1o(, I(- _, Dimensions Total habitable space 2aa floor sq.ft. Finished basement sq.ft. 0- Occupancy group Constructiop type Garage sq.ft. Deck sq.ft. . /(:',1.7 •! 7/ _u.1., 'Cost of proje �J Heat source(electric,gas,etc.) Manufac>n_M Nome ILOOM _ ' .Y• Sign; r Width. Length: What is the square footage of the sign Flow high is the sign? face? Year: Make: H of signs Area of existing signs y-x,N raS.t;,' v a_-: '� e- cr--�""`�rs,rW .e+" "'° aha F' r r i t _ sz, f_s-`'�-��'w. `&...r ��., � � vE� li s �*�...,:" h-s^x -r `zs ' * Previous address Fire Sprinkler Tent Paint booth Fire Alarm Fireworks display Proposed use Value { 1106,10111* Firm Name Phone Plans Examiner Phone Inspectors: Address Inspector Phone O Concrete 0 Welding 0 Bolting 0 Reinforcement Address `�/ ADDITIONAL SITE INFORMATION XI Are there structures on the property? Yes O No What is the current property size? If yes,identify on site plan / (square feet or acre /X/!.5 ., 4.)_/? Is any part of the property within 250 feet of a shorel- e? What is the current use of this property? Ifyes,identifyon site plan 0 Yes JNo Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes ,1!(..,No X0 Don't know 0 Yes ,�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,identify on site plan If yes,identify on the site plan O Yes X No 0 Maybe 0 Don't know 0 Yes %No Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the propert ? property? 0 Yes No Ifyes,identify on site plan O Yes S.No Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site? ( /%) O Yes )4 No 0 Yes I'No DEPARTMENT USE ONLY @ 'a i C- rA&. a y- "b Ld SJis"gym s _,. `Y i '2 1/4� e i o`�T a ie Vv4ee .3-�t�"�3 *g 0 bs :Ey,t'� ia `:rte fo- a 9 tgk Ck s* A , Date Received: Staff Representative: METHOD OF PAYMENT MEM fCCIIE A SUBTOTAL ❑ CASH ❑ CHECK ❑ ❑ _ ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: ��a yrs� r s � 7 A4 -U ' nBANK CARD NUMBER: rtir**rfjt txtsott=4 re • MAGIIESAeti)W:AE AUTHORIZED SIGNATURE: GflcINTYPF.itT�ttFCEltrt 2 { 4- e B X 14 o P // L t 1'101,s -ro t-\r2.c. � tk-N p_.s L)-43\ e..1 ra P Fi s.c o ko s E -c> LD C.A-z r, A-7.- / T/S4/ 7 E , ✓_T t✓ E ?O AO -- 50 -- C EC-zl�L el 11 f Zo#RL�"AR [YARD S6r9, Oc Lb T it. 2 TRA �CEc.TIc ADDS) 1242e GvLA1. s441:4)e —I — — 4I D, - 5--3 S,-F. I 'FA(2-c-E ` 45Z,64 Z60L t. cr Nk0 SMB , „ cot -20¢biasMuai7ATEs - rur Nil 40 Oe 0 - VTS l O is AZ - ( /`� U2R0E N - I�I ;P. L1/i�/ I , v . oPPOSED CC" . . pr.. *k 4- RA.rzS. ToP 4s, 60T-ro kg. 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