2003, 04-28 Permit App: 03002912 Patio Roof Project Number: 03002912 Inv: I Application Date: 4/28/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for•commencing work without a permit
Project In formation:
Permit Use: ROOF COVER OVER PATIO 17 X 22 Contact: DAVE THOMPSON
Address: 5219 N MAYHEW RD
C- S-Z: SPOKANE,WA 99216
Setbacks: Front EM Left: 15 Right: 20+ Rear: 150 Phone: (509)995-5048
Group Name:
Site Information: Project Name:
Plat Key: 006150 Name: RIDGEMONT EST NO 3,01ST ADD TO District: G
Parcel Number: 45251.1806 Block: 2 Lot: 6
SiteAddress: 1911 S STEEN RD Owner:Name: HANSEN,ERIC
VERADALE,WA USA 99037 Address: 1911 S STEEN RD
Location::VER VERADALE,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: 999 UNKNOWN Hold:
Area: 1,126.00 Acres Width: 100 Depth: 201 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Released By: ik)P
`74(-28'78-
Plan• ':,./. Released y: _ P[ wS
aVIVANTIMOiraliLliWal.WrAlrffliNfrOPPrgiWavirinlirlWalr-
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Permits: 4 .... 1
Operator: RMB Printed By: RMB Print Date: 4/28/2003
Project Number: 03002912 Inv: 1 Applicatipn Date: 4/28/2003 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: UNKNOWN Firm: UNKNOWN
Address: UNKNOWN Phone: (000)000-0000
UNKNOWN,WA UNKNOWN
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
COV DECK R-3 VN 374 $3,766.18 374 $3,766.18
Totals: 374 $3,766.18 374 $3,766.18
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $88.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $19.36
Permit Total Fees: $111.86
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $111.86 $111.86 $0.00 $111.86
$111.86 $111.86 $0.00 $111.86
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: 4/28/2003
1
IL PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
i 509-477-3675
SoxSPOKAIV COINIT
SPECIFIC SITE INFORMATION
• Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: fa PCL« fo Otie/` /47-40' aveei
A.Building Permit ❑ Change in Use ❑ Grading Cl 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 •
U./ Left: Right.
OWNER/APPLICANT INFORMATION
0 Indicate who.,Jwi1d be rontaaerl rc,urdan,this project
NI 594c-
tax: S7,-e—ae j X1, --e ;/t'iyt(1�/ Fax:
N1ailing address: iAlailing Address .
/77 6: //-r' '/ Z/
Cite,State,Zip City,State,tip
,,reo/i4lc 71'5/ �/' 97,e0
__firntractor Phone w./^��/1Phone
( / ,7 7 7 ❑ Architect:6n nnrcr
�e ��JG�lfl vSGV1 tax Fax
Mailing address / Mailing address
s /q ,1/ /0', V, l ,e./
Gine,State lip City,State lip
61 s*!e / CSA' 9W/X.
VV.A:ate Contractor license# Contact name:
1, "t e , •/ "1
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
l7 1
Dimensions Total habitable space 2'"t Boor sq. tt. Finished basement sq.ft.
/7"/ -' ,Y7 (
Occupancy group Construction type Garage sq.ft. Deck sg.ft.
574/G'' fj2rAlf PC
Cost cic,project I Icat source(electric,gas,etc.)
Manufactured Home Sign
Width: Length: What is i'ie square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
i
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 0 Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? Yes O No What is the current property size?
If hes,identzfi,on site plan (square feet or acres) ,..5";",CiC>±---) c'e-5270
k Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,rdentO,on site plan O Yes X No Aemf 7 ,'Er/)ewe[
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes 'No
0 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?
Ifyes,identib,on site plan Ifyes,identify on the site plan O Yes X No
O Maybe O Don't know O Yes 18,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,identify on sae plan O YesNo O Yes No
Are there slopes greater than 30%on the property?(30 ft se in 100 ft) Are critical or hazardous materials used or stored on site?
( 9) O Yes A No O Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No
O Yes O No
Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes O No
O Yes 0 N
Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource Area?
O Yes O No
Date Received: Staff Representative:
METHOD OF PAYMENT
ICMV > SUB'l'0'1'_Al.
VISA
0 C:ASII 0 C1ll CK ❑ 0 0 ---
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DVIE:: NXPIRFS: TOTAL FEE
B:ANKC:UZL)NUMBI'.R: MINIMUM PERMIT FEELS/35.001'L.P_1SE
IAIAKE CHECKS PAY=1F3LE TO SPOKANE
ALM IORIZI�:D SIGN:ATURI:: COUNTY PERMITCEN1ER
11 D1.1),\F All'NT OF LABOR AND INDtiSTith.:-;
1 '
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A , .
REGISTERED AS PROVIDED BY LAW AS
CONST CONT SPECIALTY .1
''.
.REGIST. # :EXP. DATE
CCBEBD DAVETC*016L8 07/11/2004 .0.
EFFECTIVE DATE 06/28/1999
DAVE THOMPSON CONSTRUCTION
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3924 E 28TH AVE
SPOKANE WA 99223
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F( 5-052-000(8/97)
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