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2005, 07-25 Permit App: 05002560 Pole Bldg Project Number: 05002560 Inv: I Application Date: 07/25/2005 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 30 X 40 POLE BUILDING Contact: EILERTSEN,STEVEN Address: 10304 E SPRINGFIELD AVE C-S-Z: SPOKANE VALLEY,WA 99206 Setbacks:Front 100 Left: 14 Right: 24 Rear: 6 Phone: (509)893-2691 Group Name: Project Name: Site Information: Plat Key: 000400 Name: CLACKS ADD District: Nort Parcel Number: 45174.0508 Block: Lot: SiteAddress: 10304 E SPRINGFIELD AVE Owner:Name: EILERTSEN,STEVEN Address: 10304 E SPRINGFIELD AVE Location::CSV SPOKANE VALLEY,WA 99206 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 40 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Released By: - '(,ii • Plan Review Released By: ( - Permits: Operator: K_C Printed By: K_C Print Date: 07/25/2005 Project Number: 05002560 Inv: 1 Application Date: 07/25/2005 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: (000)000-0000 Building Characteristics Group: U-1 Type: VB Total Area 1200 Building Height 18 Stories 1 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation GARAGE U-1 VB 1,200 $22,800.00 1,200 $22,800.00 Totals: 1,200 $22,800.00 1,200 $22,800.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $363.25 ACCESSORY PLAN REVIEW 1 SELECT $90.81 STATE SURCHARGE 1 SELECT $4.50 Permit Total Fees: $458.56 Notes: Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $458.56 $458.56 $0.00 $458.56 $458.56 $458.56 $0.00 $458.56 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: 07/25/2005 yBUILDING PERMIT APPLICATION WORKSHEE 3-pok ` Cit of Spokane Valley Community Development Department aneBuilding Division 7:%t� 11707 E. Sprague Avenue, Suite 106 r: Val Spokane Valley, WA 99206 _-=..�`- Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION I Street Address: /o364 . Ser , 'e W & ! ' Assessor's Tax Parcel Number(s): +57 74-, 06063 Legal Description: 7 S 'X 14G ' RecTae,/, PERMIT DESCRIPTION: Po/t G u j/d t (I. Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement El Fire Safety 0 Other OWNER/APPLICANT INFORMATION • Owner. 7°---euiert FiV erT5eo ❑ Applicant: .5a,,,,-,2— . Phone: 3-Lc Fax: Phone: Fax: Address: /0 50 4 Cpr`l!,•0,eId Address: City State Zip Code City State Zip Code ❑ Contractor: N- ❑ Architect: NA- Phone: Fax: Phone: Fax: Address: Address: City State Zip Code City State Zip Code . WA State Contractor License #: Contact: Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: / 7, 5 peer DIMENSIONS: 40X 3v #OF STORIES: MAIN FLOOR TO SQ. FTG: 1200 2ND FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: ©o�� HEAT SOURCE: #OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 5,000 30%SLOPES ON PROPERTY: SEWS R ON-SITE SEPTIC STEM? 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 n BOLTING ❑ CONCRETE ❑ REINFORCEMENT 0 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 th p ..- , owner. Print Name , -euer4 Signature 5 Method of Payment: (Faxed permit applications will only be accepted with major bankcard) 'Cash ❑ Check 0 Mastercard D VISA ❑ Other Bankcard#: Expires: VIN#: Authorized Signature: ADDRESS"� ZONE ROAD ydlDtH FRON-T COMMEND — RE�IEtN am • r 1' This site obtaining Plan is being submitted for the purpose of g a building permit and is a true and correct representation of the proposal. All known property lines/dimensions, curb lines, structures and easements have been identified. Also indicate e wetlands, bodies of w ter, -yyeap stop, P i t Signed:: critical areas. � ' : �- Date: W F' M 5y_Ln�' 17a:�4` dam'- •, L i A' I 0 S'T-J—va n