2002, 05-03 Permit App: 02003311 Addition Project Number: 02003311 Inv: 1 Application Date: 5/3/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 10' 6 X 16 DINING ROOM ADDITION Contact: INTEGRITY REMODELING
Address: P.O. BOX 8556
C - S -Z: SPOKANE,WA 99209
Setbacks: Front 30+ Left: 13 Right: NA Rear: 50 Phone: (509)455-4395
Group Name:
Site Information: Project Name:
Plat Key: 002646 Name: TIMBERLANE ADD District: F
Parcel Number: 45253.0110 Block: Lot:
SiteAddress: 2520 S TIMBERLANE DR Owner: Name: HUBBLE,JAY& TAMMY
VERADALE,WA 99037 Address: 2520 S TIMBERLANE DR
Location::VER VERADALE,WA 99037
Zoning: UNKN Unknown
Water District: Hold: ❑
Area: 8,350 Sq Ft Width: 61 Depth: 153 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 10
Review Information:
Review
Site Plan Review Released By: I 6/ "j / t❑
7;
Plan Review '�
Released B
Permits: ..
Operator: DMD Printed By: DMD Print Date: 5/3/2002
Project Number: 02003311 Inv: 1 Application Date: 5/3/2002 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: INTEGRITY REMODELING Firm: TODD KUBICEK-INTEGRITY R
Address: PO BOX 8556 Phone: (509)455-4395
SPOKANE,WA 99203
Building Characteristics
Const Category: Addition Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: El
This Application: Total Project:
Description Grp Type Notes So Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 168 $11,088.00 168 $11,088.00
Totals: 168 $11,088.00 168 $11,088.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $188.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $41.36
Permit Total Fees: $233.86
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $233.86 $233.86 $0.00 $233.86
$233.86 $233.86 $0.00 $233.86
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 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: DMD Printed By: DMD Print Date: 5/3/2002
! 1APROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
SPOKE NJY COU 509-477-3675
SPECIFIC SITE INFORMATION
Street Address: L 5-20 -5-1 Y ' -( < Or;v
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: 4ici'e-"'t^
1 Building Permit ❑ Change in Use ❑ Grading ❑ 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
Left: Right:
OWNER/APPLICANT INFORMATION
El Indicate who should he contacted regarding this project
4n1 Owner: Phone: 89/_ ca 7( 7 ❑ Applicant: Phone:
7•:7 d- 11--„,..„..,7 lf.,..Sbi e_ las: las:
Mailing Address: Mailing Address:
2.- 2 Cl .. T.',-.1 y-4“.., ,r.'v-_
City,State,Zip City,State,Zip
.1h,h.<, 4,4.9 9goj7
An Contractor �1 Phone ',Sy_ti 3,..5— ❑ Architecbl:ngineer Phone
�%ti�et-,',{/�,, /1 Gwos���.n his l'as
Mailing address
/ Mailing address
Pc'" F/OK S.rS 6
City,State Zip .A \°IC' City,State Zip
\CA State Contractor license# Contact name:
,97"i77— 6R d/r_'E-/
PROJECT INFORMATION
Building Information
Building height to peakI #of stones / Main floor sq.ft. Unfinished basement sq.ft.
/2
Dimensions Total habitable space .2'"1 floor sq.ft. Finished basement sq.ft.
`
/C`—G "X /h/
Occupancy group Construction hype �J Garage sq.ft. Deck sq.ft.
t�'6o cC
Cost of project I[eat source(clectne, as2etc.)
qZSo .61' C� e-X3 !!,t
Manufactured Home
Width: Length: What is the square footage of the sign Flow high is the sign?
face?
Year: Make: #of signs Area of existing signs
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 O Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? s Yes O No What is the current property size?
If yes,identi on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan 0 Yes No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes 0 No
0 Don't know 0 Yes gi No
Is any part of the property within a 100 yr flood plain? Arc or will there be wells located on the property?
I[yes,identibi on site plan If yes,ident'on the site plan 0 Yes 'No
0 Maybe 0 Don't know 0 Yes $I No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
If yes,identifi on site plan 0 Yes i No 0 Yes Ad No
Arc there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
O Yes Er 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
OYes 0 N
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
OYes 0 N
Date Received: Staff Representative
METHOD OF PAYMENT
lIC!!ti SUBTOT A].
VISA
0 CASA 0 CI II,:CK ❑ ❑ ❑ R-
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATI?: 1?\PIR1?S: TOTAL FEE
BANKCARD NUMBI'.R: MINIMUM PERMIT FEE IS$35.A7PLE SE
MAKE CHECKS PAYABLE TO SPOKANE.
AUl l lORIZED SIGN:I'I URI:: COUNTY PERMIT CENTER
Th;c c to plan is heing. cihmitted for thepurpose of
` a a true and correct
/1 lei- „_ecz,, represer c of The proposal All known property
ADDRESS )52U lines/dimensions,curd ;res structures and easements
ZONE r
have teen identified ,A'sc indicated are wetlands,
ROAD WIDTH 0 0 bodies of water,steep siopes or other critical areas.
FRONT i F,Ask iNG — Signed: ?-7.-rt—' 7/16-'
wetlandsAIM 47 .
Allow f i gate.' 7 ' -°-a
REVIEWED B AIWA
—Air
50
N wwAA
1 s”
- o e� --- ,
s A lir /o!�w W
.A �' �
\ /t / . 44.16.
3.
O \•i
co
137
5(74"-e- tom` p I4,..