2003, 12-10 Permit App: BLD-03-03238 Garage Addition `ITYF ems'`
��an . ,
.0,00Valley 4 '
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone:(509)688-0036 Fax:(509)688-0037
1 REQUIRED SITE INFORMATION II
0
STREET ADDRESS: _ "'S ' -,- / ,e/��/ �5)‘,c%
ASSESSOR'S TAX PARCEL NUMBS S): _Z.179,/. /--W
YACC/77 LEGAL DISCRIPTION: %'/ OJT '- 2 '/1"
PERMIT DESCRIPTION: ,eva t�� ec z/ 'ems
BUILDING PERMIT UCHANGE IN USE a GRADING ®MANUFACTURED HOME
RELOCATION Q SIGN 0 TENANT ®OTHER
OWNER / APPLICANT INFORMATION
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OWNER: i ® APPLICANT:
PHONE: 9-(77-7E//,,‘/ l _FAX: Y'y��� PHONE: FAX:
ADDRESS: /Oii�rL��G/G --5lo� 2 ADDRESS:
CITY, TATE,ZIP CITY,STATE,ZIP
®CONTRACTOR: V ® ARCHITECT:
PHONE: FAX: PHONE: FAX:
ADDRESS: ADDRESS:
CITY,STATE,ZIP CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE# CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: /7 vp 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
BUILDING HEIGHT TO PEAK: I 1 OCCUPANCY GROUP: 2ND FLOOR SQ FT:
BUILDING DIMENSIONS: 0/ CONSTRUCTION TYPE: UNFIN BASEMENT:
NUMBER OF STORIES: / STRUCTURES ON PROPERTY: 2 FINISHED BASEMENT:
NUMBER of BEDROOMS: 0 CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: DECK:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE: I/O
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
II MANUFACTURED HOME SIGN j�
WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN:
YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN:
MANUFACTURER: TYPE OF SIGN:
I RELOCATION FIRE SAFETY
1
PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
PROPOSED USE: FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE 1
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
I SPECIAL INSPECTIONS
a BOLTING °CONCRETE 0 REINFORCEMENT ® WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
BUILDING STAFF USE ONLY
1
IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: ® COUNTY ® CITY
IS PUBLIC WATER AVAILABLE: ® YES 0 NO IF YES,WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES 0 NO
IDATE: ' STAFF: I
METHOD OF PAYMENT:
® 0 0r -'-am; a 1111111111.111111111
CASH CHECK L. VISA
BANKCARD#; EXPIRES: VIN#
AUTHORIZED SIGNATURE
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
12/10/2003 13:20 5093241567 SRHD EHS PAGE 03
DEC 07 2003 12:38 FR TO 3241567 P.03/03 .
/ " ' f • SPOKANE. a LINTY'HE LT.H .DISTRICT y
I ALTH OFFICER ' ,
� - � '. � E�O: PLOEt�ER. M. D.. M.P.H.. H.
N 81iJefferson Stteet• ,;:; ; .
Spokane:Washington 99201r.
DATF /' - f
pawn- N0. t Q
' f• ? No 0 68.87 .
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Nome li&:11 #4"edrpas - gone No.
Address of Proposed Site g .37.S'" •
Type of Use �--042---"1 Ys basement foe building plstined?
Number of Bedrooms 2--- r+ilding Camp*city Camp Capacity Other .r,_._r.
Water Supply. 209 ' (City, Well. Spring). Drywall---------------
Septic tank capacity. 2...re' .gala. Style of tank
3 r Absorption Pits icach Bed_..�,�
Length of diopeasil field— l� tion P
(1) Show relative location of: Proposed house, septic tank. efe'
disposal field, well, garage and ether out buildings.
(2) Make note of any heev elope se swampy area es any'
other Impartaat t lc details. _ _
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J
164
1441(V)4)/i 6 q i°""‘42 4
OOP ,...._1.— .......... ,.4.1° ( . . 4 •
p-b 20„ 60.40. tit, s7 •
f 6111 A44(4.* / I 1
" j 10
t*.clky I7 i (5 W
• -;sit . •1 • • \ �
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6
Installer -,ymA"i• -Ai ,:....
r .70 �1I�
Final Itirpaotion Dai,./lei % � - f
Remarks: .. .
A , i
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CON . RA,,,...riti,
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ro $ 4 Nsr.NtstTN For Spokane County Heath10
District '1411
*>k TOTAL PAGE.03 **
DEC 07 2003 13:28
5093241567 PAGE.03
12/10/2003 13:20 5093241567 SRHD EHS PAGE 04
PADAL- Fact Sheet Page 1 of 1
4 '
Spokane County. Parcel Data Locator
:..e.
•
Wean Courit9. . • .. . ......_
All Data As Of Tuesday,December 09,2003
Summary Parties Values Sales Info Set/MerE9' Events/Notices Land 1®preme
rds
Fact Sheet w/o Taxes Fact Sheet-Taxes Only, FactShegt vIth Taxes
. Fact Sheet without Taxes for Property Number 35141.1322
All Data As Of Tuesday, December 09, 2003
Site Address 5615 E DESMET AVE,SPOKANE TCA 0140 Parcel Status Active
Owner CROCKER,ROY Taxpayer CROCKER,ROY
Address 7818 E LIBERTY Address 7818 E LIBERTY
SPOKANE,WA 99212- SPOKANE,WA 99212-
i
Acreage Market Values 2003
Land Sq Feet 25,000 Land 80,000 Exempt Value 0
Property Class 11 Single Unit Improvements 12,100 Personal Property 0
Total Valuo 92,100
Exemption Year 2003 Active Exeymptions
Legal Description
.
TOWN OF YARDLEY LTS 9 THRU 12 BLK 16
Improvements
Improvement Type Description Year Built Size UOM
Dwelling Dwelling
1947 775 SF
Other Fencing-Chain Link 1986 666 LF
Created on Wednesday,December 10,2 03 at 1:15:55 PM
Jielo NewUarc l MOIlLSAPIO Prr
... . -~- Sookone County Truesurat4A0tfice
119999011990119 Mels Stop 0C113.498011 PO Box 199
Spokats,WA 99210-0159
1118 West Broadway Avenue
County Courthouse,lot Floor
sponene,WA 99280
flours Monday.Friday 8:20am-6:00pm(excluding holidays) flours Monday.Friday 8:30am-6:00pm(excluding holidays)
Phone(609)477-3898 Phone(509)4774713
fax(509)477-8697 Fax(609)4773874
NM ALigagranSikanegeadY.O.Ig MAI T(Bgulert apokanecountv.org
http://muscalwebpadalx/ParcelFactSheet.asp?Ty ie—NoTax
12/10/2003
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DEC 07 2003 13:28 5093241567 PAGE.04
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