2003, 03-03 Permit App: 03001270 Addition Project Number: 03001270 Inv: 1 .Applitation Date: 3/3/2003 Page 1 of 3
THIS I NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: ADDITION TO RESIDENCE-GREAT ROOM & Contact: GONDER, GEORGE
KITCHEN Address: 16822 E VALLEYWAY
C -S -Z: VERADALE,WA 99037
Setbacks: Front EXI Left: 14 Right: 30 Rear: 100 Phone: (509)927-3892
Group Name:
Site Information: Project Name:
Plat Key: Name: District: F
Parcel Number: 45134.1015 Block: 10 Lot:
SiteAddress: 16822 E VALLEYWAY AVE Owner: Name: GONDER,GEORGE
VERADALE,WA USA 99037 Address: 16822 E VALLEYWAY
Location::VER VERADALE,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 67 Depth: 640 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review C"" � Released By iJ1 j,
li?(-06N •
Plan ReviewReleaseel By: � '
Septic System Review Released By:
❑ f r'- ` = c �
P y sewage res!gaed
0
Permits:
Operator: RMB Printed By: RMB Print Date: 3/3/2003
Project Number: 03001270 Inv: 1 Application Date: 3/3/2003 Page 2 of 3
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: Addition Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: E
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RES ADD R-3 VN 860 $56,760.00 860 $56,760.00
OW deb.:-
145 e Totals: 860 $56,760.00 860 $56,760.00
Item Description Units Unit Desc Fee Amount
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $137.23
RESIDENTIAL VALUATION 1 Y OR BLANK $623.75
Permit Total Fees: $765.48
Mechanical Permit
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 2 NUMBER OF $20.00
CLOTHES DRYER 1 NUMBER OF $10.00
RANGE 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
LPG TANKS 1 NUMBER OF $10.00
Permit Total Fees: $63.00
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 1 NUMBER OF $6.00
SINKS 2 NUMBER OF $12.00
SHOWERS 1 NUMBER OF $6.00
DISH WASHERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
Permit Total Fees: $36.00
Operator: RMB Printed By: RMB Print Date: 3/3/2003
Project Number: 03001270 Inv: 1 .Application Date: 3/3/2003 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes .
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $765.48 $765.48 $0.00 $765.48
Mechanical Permit $63.00 $63.00 $0.00 $63.00
Plumbing Permit $36.00 $36.00 $0.00 $36.00
$864.48 $864.48 $0.00 - �`
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: 3/3/2003
1 PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
Air,1k
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
SPOKE CaKrY
SPECIFIC SITE INFORMATION
Street Address: :6 2Z.. e 1/,¢LE,---yw,�y
Assessor's Tax Parcel Number(s): �S—/r3V /OJS
Legal Description: 7 J
//i- r//o 1310
Project Description: /fid✓,h6t/ /O ...C. /ST//(7 /4.t/Xe-
building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign 11 Tenant(New/Change) ❑ Other
Deparunent Use Only
Fater District/Purveyor. Sewer District/Purveyor Road width Setbacks
Front Rear.
School District. Fire District Zoning.
Left Right
OWNER/APPLICANT INFORMATION
{, El Indicate who should be contacted regarding thirpreyel
yep lhcnet- Phone " 2 fot 3 45,92..... 131 Applicant: Phone:
1176—
Vlading Sddre,, Mailing Bit Address-
/.4g2– E, y y
(an1.,St te,"/.ip Cin,State,Zip�-� /9L�� �t/1�. 99037
PhonePhone
❑ Contractor Q �j ❑ Architect/Engineer
5,/////L` Fax lax
Mailing address Mailing address
Cin-,State Zip City,State Zip
VA A State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
i I
Dimension/�Total habitable space 2"rt floor sq.ft. Finished basement sq.ft.
2 A 2- 440 s4. FT•
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project I teat source(electric,gas,etc.)
Manufactured Home Sign
Width: Length: What is the square footage of the sign I low high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler 'fent
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 ❑ Welding ❑ Bolting ❑ Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? X Yes ❑ No What is the current property size?
Ifyes,identify on site plan (square feet or acres) / /14,1,6-
Is any part of the property within 250 feet of a shoreline? A\hat' the current use o ns pr)pert$?
Ifyes,ident�on site plan ❑ Yes N No Ki?llr4W7f/
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?Ar Yes ❑ No
❑ Don't know ❑ Yes Xi No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
Ifyes,identifyon site plan Ifyer,identify on the site plan ❑ Yes A NO
❑Maybe Don't know ❑ Yes ❑ 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,identifif on site plan ❑ Yes X No O Yes PI No
Arc there slopes greater than 30°%on the property?(30 ft rise in 100 ft) Arc critical or hazardous materials used or stored on site?
( °'o) ❑ Yes No ❑ Ycs1111' No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? ❑ Yes ❑ No
❑ Yes ❑ No
Is the property inside the ASA? ❑ Yes ❑ No Is public water available to the site? ❑ Yes ❑ No
❑ Yes 0 N
Is the property inside the PSSA? ❑ Yes ❑ No Is the property located within 1000 feet of a Natural Resource Area?
OYes 0 N
Date Received: Staff Representative:
METHOD OF PAYMENT
Min !COW SUBTOTAL
VISA
0 C:ASII 0 CHUCK ❑ ❑ 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D:A"I'l I?1 PI R I(S: TOTAL FEE
B.ANKC.VtD NUIBI{It: MINIMUM PERMIT FEE LS$35.00 PLEASE
MAKE CHECKS P_'Y:VILE TO SPOKANE{
AUC]IURI%1:1)SIGN.VI FRF: co[NTv PERMIT CENT ER
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