2001, 08-28 Permit App: 01007300 Addition Project Number: 01007300 Inv: 1 Application Date: 8/28/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project In formation:
Permit Use: RES ADD-DINING ROOM ADDITION Contact: BEN PETERSON CONSTRUCTION
Address: 11516 E 6TH AVE
C-S-Z: SPOKANE,WA 99206
Setbacks:Front Left: Right: Rear: Phone: (509)990-5167
Group Name:
Site Information: Project Name:
Plat Key: 001218 Name: HILL VIEW ESTATES District: F
Parcel Number: 45273.0904 Block: Lot:
SiteAddress: 12420 E SKYVIEW AVE Owner:Name: HUBBARD,DAVE
SPOKANE,WA USA 99216 Address: 12420 E SKYVIEW
Location::SPO SPOKANE WA 99216
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 80 Depth: 130 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review In formation: sime r� :-_. .... „1",A z.t,c1rMASs
Department Review
BUILDING Site Plan Review Released By:
Hold Reasons:
Permit Conditions:
Originally Released: 8/28/01 By: jshatto
BUILDING Plan Review Released By:
Hold Reasons:
Permit Conditions:
Originally Released: 8/28/01 By: jshatto
Project Number: 01007300 Inv: 1 Application Date: 8/28/01 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: BEN PETERSON CONSTRUCTION Firm: BEN PETERSON CONSTRUCTION
Address: 11516 3 6TH Phone: (509)990-5167
SPOKANE,WA 99206
Building Characteristics
Const Category: Addition Group:R-3 Type: VN
Nbr Of Dwellings: 1 Occupant Load: Building Height: 12 Stories: 1
Bldg W x D: 14 x 14 Building Sq Ft: 196 Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: 0
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 196 $12,152.00 196 $12,152.00
Totals: 196 $12,152.00 196 $12,152.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $200.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $44.11
Permit Total Fees: $249.11
Payment Summary:
Operator: JAS Printed By: JAS Print Date: 8/28/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $249.11 $249.11 $0.00 $249.11
$249.11 $249.11 $0.00 $249.11
ti
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
SPOx COUNT'
SPECIFIC SITE INFORMATION
Street Address: .
c Q TI1T sKyveiLd
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: ILl K Iy Acd;4Icii
ItIA Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor Road width Setbacks
Front Rear.
School District Fire District Zoning
Left Right:
OWNER/APPLICANT INFORMATION
(� Indicate rvho should be contacted regarding this pro/ea
❑{(�Oxvner: p�n Phone ❑ Applicant: Phone
Ok 1-1 U g eA lr j Fax: pax:
Mailing Address: Mailing Address:
ItA`IOZO CAST Sk' treri;
City,State,Zip City,State,Zip
SPGJA
"FtContractor Phone jGe/-701;(x ❑ Architect/Engineer Phone
6-7J E I N(11-J 61.1yr
lax I ax
Mailing address Mailing address
I I S r6 6 c, ati
City,State Zip Cita,State Zip
SvcKettJf lVA r17.0�
WA State Contractor license# Contact name:
geld PEC4( Dal—9
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
AMOX I2' I Z16
Dimensions Total habitable space 2nd floor sq.ft. Finished basement sq.ft.
Occupancy group Construction
-pe Garage sg. ft. Deck sq.ft.
Jt X I rt,dm
Cost offrroject I Teat source(electric,gas,etc.)
/
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Arca 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 O No What is the current property size?
Ifyes,ident'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,ident'on site plan 0 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 0 Yes 0 No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
Ifyes,identify on site plan Ifyes,identifi on the site plan 0 Yes 0 No
0 Maybe 0 Don't know 0 Yes O No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
Ifyes,identi on site plan 0 Yes 0 NO 0 Yes 0 No
Are there slopes greater than 304/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? Yes 0 No
0 Yes No
Is the property inside the ASIA? Yes 0 o Is public water available to the site? XYes 0 No
Yes 0 No
Is the property inside the PSSA? Yes 0 No Is the pro.e r'located within 1000 feet of a Natural Resource Area?
0 Yes No
Date Re wej: Staff Representative:
METHOD OF PAYMENT
MOM S U B"1'OT;AI,
VISA
❑ CASA ❑ CIII:CK ❑ ❑ ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
I[\Pl RI?S: TOTAL FEE
IS ANKCARD NUNBI':R: MINIMUM PERMIT FEE IS$35.00PLEASE
;;MAKE CI IECKS PAYABLE TO SPOKANE
ALAI TORI%I?D SIGNATURE: COUNTY I'ERVMIT CENTER
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This site:tan is being submitted for thepurpose of
obtaining a buildina permit and is a true and correct
representation of the proposal.All known property
lines/dimensions,curb lines structures and easements r'.
have been identified. Aso indicated are wetlands,
li *'
bodies of watest sores or other critical areas.
Signed: j /�/�'�1=� ly i �, v
Date: ,,-Li-0/ .t--)
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