2002, 05-16 Permit App: 02003785 AdditionProject Number: 02003785 Inv: 1
Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Project Information: ., m. a•v �. . -_w
Permit Use: SUNROOM & OFFICE ADDITION Contact: WILSON, DAN
Address: 4004 S SUNDOWN DR
C - S - Z: SPOKANE, WA 99206
509
Setbacks: Front NA Left: Right: Rear: Phone: (509) 928-6710
Group Name:
Site Information:
Project Name:
"v,/ . ,= a .ate a .�. 47/^:: N .- .,,,W3, m V
Plat Key: 002082 Name: PONDEROSA 1ST ADD District: E
Date: 5/16/02 Page 1 of 2
Parcel Number: 45324.0107 Block: Lot:
SiteAddress: 4004 S SUNDOWN DR Owner: Name: WILSON, DAN
SPOKANE, WA 99206 Address: 4004 S SUNDOWN DR
Location:: SPO SPOKANE, WA 99206
Zoning: UR -3.5
Water District:
Area: 0 Sq Ft
Urban Residential 3.5
Hold: ❑
Width: 118 Depth: 150 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Li-ADA/6- ctn.ein
Septic System Review
Permits:
Released By:
f -1,
Released By:
Released By:
Operator: CKF Printed By: CKF
Print Date: 5/16/02
Project Number: 02003785 Inv: 1
Apr��n
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Firm: OWNER
Phone:
Building Characteristics
Const Category: New Group: R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: 13 Stories: 1
Bldg W x D: 20 x 20 Building Sq Ft: 417 Sprinklers:
Req Parking: Handicap Parking: Critical Materials: ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation So Ft Valuation
RES ADD R-3 VN 417 $27,522.00 417 $27,522.00
Date: 5/16/02 Page 2 of 2
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:r; �..;
Payment Summary:
Permit Type
Building Permit
Totals: 417 $27,522.00 417 $27,522.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Fee Amount Invoice Amount
$466.88
$466.88
$466.88 $466.88
Fee Amount
$379.00
$4.50
$83.38
Amount Paid
$0.00
$0.00
$466.88
Amount Owing
$466.88
$466.88
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 contrued 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: CKF Printed By: CKF
Print Date: 5/16/02
1
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4711.,
1
SPOT COUP
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s): I �� �� 7
Legal Description:
/40,D4oS,4 /9- D<Di7ia" L 7 g
Project Description:
fJ /2'a /a� i� e ,2).)>/ria/1--)
Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
❑ Sign
O Tenant (New/Change)
O Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear.
Left Right:
School District
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
El Indictee who should he eonladed re2ardin2,bir firoiect
P (hence / I / C.- NI
TA/0 1 6: ( J .- / ?CJ
(i.
Phone: 5-69 go 6 -6-7/ e)
Fax:
0 Applicant.
Phone:
I ax:
Mailing Address:
44 .
u,,JDotAJA)
DI -
Mailing Address:
Finished basement sq. ft.
City, State, Zip
Construction type
Garage sq. ft.
City, State, Zip
Cost of project
0 Contractor
Phone
Fax
Architect/Gn},'inecr
AV ri Sec, �S
S ATS
Phone 3 07 Sg_s---i' L 5j
lax
Mailing address
Mailing address
/9e 4 L . Tf/i,/i y /-----7-/-/ /
4 /4--
Cin, State Zip
City, 5 ate Zip
VV'A State Contractor license #
Contact name
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
tet floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
I feat source (electric, gas, etc.)
Manufactured Home
�„. r>
Width:
Length:
What is the square footage of the sign
face?
I Iow high is the sign?
Year:
Make:
# of signs
Area of existing signs
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /- %) ❑ Ycs Xt No
Proposed use
Value
Relocation
Fire Safety
Firm Name
Previous address
Phone
Fire Sprinkler
Tent
Paint booth _ Fire Alarm
Fireworks display
Is there evidence of fill or excavation on the property?
❑ Ycs No
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /- %) ❑ Ycs Xt No
Proposed use
Value
Special InspectionsRequired?
Non -Residential Energy Code Compliance?"
Firm Name
W at is the current use of this property?
6s 0) /(le
Phone
Will the site be served by a septic system?,$ Yes ❑ No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
❑ Ycs No
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /- %) ❑ Ycs Xt No
Arc critical or hazardous materials used or stored on site?
❑ Yes No
Address
Inspector
Phone
❑ Concrete
❑ Welding
❑ Bolting
❑ Reinforcement
Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? A Ycs ❑ No
Ifyes, idem/y on site plan
What is the current proper size?
(square feet or acres) 16 O ,Q i—
Is any part of the property within 250 feet of a sh�j)rrcline?
Ifjes, idem on site plan ❑Ycs �1 No
W at is the current use of this property?
6s 0) /(le
Is your property in a designated wildlife habitat arca?
❑ Don't know ❑ Ycs No
Will the site be served by a septic system?,$ Yes ❑ No
Is any part of the property within a 100 yr flood plain?
If yes, ident on site plan
❑ Maybe Don't know ❑ Ycs ❑ No
Are or will there be wells located on the property?
Ifyes, identi,b' on the site plan ❑ Ycs ❑ No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyer, idem' on site plan ❑ Ycs ❑ No
Is there evidence of fill or excavation on the property?
❑ Ycs No
Arc there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /- %) ❑ Ycs Xt No
Arc critical or hazardous materials used or stored on site?
❑ Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
❑Yes CI No
Is public sewer available to the site? ❑ Yes Q No
Is the property inside the ASA? ❑ Yes ❑ No
❑ Yes ❑ No
Is'ajiublic water available to the site? ❑ Yes in No
Is the property inside the PSSA? ❑ Yes ❑ No
Is the property located within 1000 feet of a Natural Resource Area?
❑ Yes ❑ No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ (;:ASI1 (:1IKCK ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
U:1'1E:
I AMR]
:S:
B.ANKCARI NLIMBI.:R:
LITI IORIZFI) SIGN.V1'URI::
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.00PLEASE
MAKE CIIECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
a . c„„t
sitern' is be:111g ki.litifnItted‘ ter tne'CiU'rOcse Of
ainin •:a atrue and correct. - •
bt.ter oi-optsol: known ProPertY
tblineS-'structures and easernent
h70,' /10 irldiqated are wetlands,
CCtJ
ter -.otfler "cal areas.
-Date.
ADDRESS
ZONE
ROAD VIvr 1
FRONT - F L ANKING
'COWMEN S
REVIFWED BY
t -or
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