2004, 06-21 Permit: BLD-04-04674 Residence- Spokane
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11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
NEW SINGLE FAMILY RESIDENTIAL PERMIT
Job Address: 804 S SHELLEY LAKE LN
VERADALE WA
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
MADDEN, KEVIN M
MADDEN CONSTRUCTION
10601 E NIXON LN
SPOKANE VALLEY, WA 99206
KEVIN MADDEN CONSTRUCTION
10601 E NIXON LN
SPOKANE WA 99206-3794
Lot:
Blk: Parcel No:
Phone: (509) 924-6497
Phone:
Lic No:
(509) 927-7526
KEVINMC146J5
Permit #:
Applied:
Issued:
Expires:
BLD -04-04674
Zoning:
06/21/2004
06/24/2004
12/21/2004
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER PIPING/DRAIN-IN WASTE
WATER USING DEVICE
FUEL BURNING APPL <= 100,000 1
GAS LOG, INSERT, FIREPLACE 2
RANGE 0
DRYER 1
FUEL BURNING WATER HEATER 1
GAS PIPING (ea. OUTLET) 4
VENTILATING FANS 3
TYPE II HOOD 1
sfr
238564
32
41 x 58
2
3
30
65
6
6
r-3
5-n
1
70 x 137
no
no
2
2
1
5
1
1
1
1
1
3
Fees:
PLAN CHECK FEE
TYPE II HOOD
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER PIPING/DRAIN-IN WASTE
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
Total Calculated:
Deposits/Receipts:
Total Due:
708.86
10.00
1,772.15
4.50
12.00
12.00
6.00
30.00
6.00
6.00
6.00
6.00
6.00
18.00
15.00
20.00
10.00
10.00
4.00
30.00
2,692.51
2,692.51
0.00
THIS IS NOT A RECEIPT
Spokane
NEW SINGLE FAMILY RESIDENTIAL PERMIT
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206 Permit #: BLD -04-04674
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.
wnership of resulting development rights granted by any issued jp rmit inure to the property owner.
c>
'a-n/e )19 .a..✓
Print Name
Staff Initials
Signature Date
THIS IS NOT A RECEIPT