2001, 02-23 Permit App: 01001039 AdditionProject Number: 01001039 Inv: 1
•Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/23/01 Page 1 of 2
Project Information:
Permit Use: ADDITION TO FAMILY ROOM
Setbacks: Front NA Left: 13 Right: NA Rear: 76
Site Information:
Plat Key: 002082 Name: PONDEROSA 1ST ADD
Contact: TELLINGHUSEN, JASON
Address: 4009 S SUNDOWN DR
C - S - Z: SPOKANE, WA 99206
Phone: (509) 893-1383
Group Name:
Project Name:
District:
F
Parcel Number: 45324.0304 Block:
SiteAddress: 4009 S SUNDOWN DR
SPOKANE, WA 99206
Location:: SPO
Zoning: UR -3.5
Water District:
Area: 0 Sq Ft
Urban Residential 3.5
Lot:
Owner: Name: TELLINGHUSEN, JASON
Address: 4009 S SUNDOWN DR
SPOKANE, WA 99206
Hold: ❑
Width: 100 Depth: 165 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: tip.
Department
BUILDING
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Co ditions:
Review
Site Plan Review
Plan Review
ALTH �,i STRICT Septic System Review
Hold Reasons:
Permit Conditions:
Permits:
elea
ed By:
Project Number: 01001039
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/23/01 Page 2 of 2
Contractor: OWNER
Address: 0
000000, 00
Const Category: A
Nbr Of Dwellings:
Bldg W x D: 13
Req Parking:
Description
RES ADD
000000
Building Permit
Finn: OWNER
Phone: (000) 000-0000
Building Characteristics
ddition Group: R-3 Type: VN
Building Height: 10 Stories: 1
280 Sprinlders: ❑
Critical Materials: ❑
This Application: Total Project:
Grp Tvpe Notes Sq Ft Valuation Su Ft Valuation
R-3 VN 280 $17,360.00 280 $17,360.00
Occupant Load:
x 22 Building Sq Ft:
Handicap Parking:
Totals: 280 $17,360.00 280 $17,360.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $263.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $57.86
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
DUCT SYSTEMS
MINIMUM FEE ADJUSTMENT
Payment Summary:
Operator: DMD
Permit Type
Building Permit
Mechanical Permit
Notes:
Permit Total Fees:
Mechanical Permit
$325.36
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 Select
Printed By: DMD
Fee Amount
$325.36
$35.00
Permit Total Fees:
Print Date:
Invoice Amount
$325.36
$35.00
Fee Amount
$10.00
$25.00
$35.00
2/23/01
Amount Paid Amount Owing
$0.00 $325.36
$0.00
$360.36 $360.36 $0.00
SPOKE COUN FY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
1-1031
SPECIFIC SITE INFORMATION
Street Address: ) -5 '000(-)0‘,04 UT
,_?O
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: /Oct5e df.&(J.71 cy)
® Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted reeardiny this project
MOwner: Phone: i '' j9J
7070 n JC; ((+r+o hU ic? Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:I
110061 5 . S mr'd0'X tc Gr,
Mailing Address:
Main floor sq. ft.
,gd
City, State, ZipCity,
,<,-poka ine, w74 17 a(
State, Zip
Total habitable space
0 Contractor Phone
Fax
in Architect/Engineer
Phone
Fax
Mailing address
Mailing address
Deck sq. ft.
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
PROTECT INFORMATION
,�.F ` kF
}" Nast .. 4""�' v+ T i .M+Y
t 5�#`{�' '�$ar F '. d
�� F , ur..;. .y ...r...- •'. . , .. ..;. .., ^s..r -'.�
:.� 5' 4 phi • i • S ^ i4 i, $ t^
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F 2 FEE`+w i f ✓n5 `itt�-�M .•i:'� "`�y�41 r "iI Mz fCB6�§"
•R. *'M�:• v.Y.�ck �•.t:"v�$�:.+iC �Yd�����.t. �hN°.,,:. p� �aY�Jd,'� +�s�"�c`Y.>�� s� , . �� �. , sa_. i � u. .�s;a.
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> �^i S F ,� L� •} >T
}alF, f rRR 3::e'��..nE �..�I'� Y'•�1'�',^a.'htifl-'�" ���r.
Building height/ to peak
10 lqe.�
# of stories
1
Main floor sq. ft.
,gd
Unfinished basement sq. ft.
Dimensions f
`13 x .2-l 06) I10 Oi
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project�x
V
Heat sourcerc"(electric, gas, etc.)
/"
10
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
Firm Name
Phone
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
O Concrete 0 Welding 0 Bolting O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 17 Yes 0 No
yes, identify on site plan
What is the current property size? 4'4"If
(square feet or acres) /6,000
Is any part of the propeny within 250 feet of a shoreline?
If yes, identify on site plan 0 Yes —gr\ No
What is the curre1 it use,of this property?
(a s , d ext -t- a
Is your property in a designated wildlife habitat area?
12f -Don't know 0 Yes 0 No
Will the site be served by a septic system? [3 Yes 0 No )
Car vc7"7` - SCa y vr Y
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
RI Maybe Don't know 0 Yes 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes 13- No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan 0 Yes No
Is there evidence of fill or excavation on the property?
0 Yes . No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ %) 0 Yes 41 No
Are critical or hazardous materials used or stored on site?
0 Yes 41 No
DEPARTMENT USE ONLY
Date Received:
METHOD OF PAYMENT
Sta
VISA
❑ CASH ❑ CHECK ❑ NM=❑ _ ❑
';IC 'Ji
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
EXPIRES:
SUBTOTAL
00
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This
obtaini
represen
lines/dimensions, cu
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e plan is tieing su
a building permit
• of the prop
itted for the
d is a true a
. All known
Ines, structures and eas
pose of
• correct
pro. rty
have been identified. Also indicated are wetlands,
bodies of war, steep...gal= or ther critical areas.
Signed:
Date: r/ s2 -*Q 1
C
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