2001, 08-07 Permit App: 01006538 Pole BldgProject Number: 01006538 Inv: 1
Application
Date: 8/7/2001 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
............. .
Permit Use: 24 X 24 POLE BUILDING
Setbacks: Front 50+ Left: 65 Right: 20+ Rear: 5
Site Information:
Plat Key: CONV Name: CONVERTED CNTY DATA
Contact: HOLBROOK COMMERCIAL
Address: PMB271 E. 9116 SPRAGUE
C - S - Z: SPOKANE, WA 99206
Phone: (509) 535-6938
Group Name:
Project Name:
District: F
Parcel Number: 45164.0303 Block:
SiteAddress: 12122 E VALLEYWAY AVE
SPOKANE, WA 99216
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Lot:
Owner: Name: SHAG HOLDINGS
Address: 1912 E SOUTHEAST BLVE
SPOKANE, WA 99203
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Department Review
BUILDING Site Plan Review
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Conditions:
g
1® iil '�.,....Awk
Plan Review
HEALTHDISTRICT Septic System Review
Hold Reasons:
Permit Conditions:
Lliteleased
Project Number: 01006538 Inv: 1
Application '
Date: 8/7/2001 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: HOLBROOK COMMERCIAL Firm: HOLBROOK COMMERCIAL BLD
Address: E. 9116 SPRAGUE PMB 271 Phone: (509) 535-9816
SPOKANE, WA 99206
Building Characteristics
Const Category: New Group: U-1 Type: VN
Nbr Of Dwellings: 1 Occupant Load: 0 Building Height: 14 Stories: 1
Bldg W x D: 24 x 24 Building Sq Ft: 576 Sprinklers: 0
Req Parking: 0 Handicap Parking: 0 Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VN 576 $6,912.00 576 $6,912.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Payment Summary:
Operator: RMB
Permit Type
Building Permit
Totals: 576 $6,912.00 576 $6,912.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Printed By: RMB
Permit Total Fees:
Fee Amount
$125.50
$4.50
$27.61
$157.61
Print Date: 8/7/2001
Fee Amount Invoice Amount Amount Paid Amount Owing
$157.61 $157.61
$0.00 $157.61
$157.61 $157.61 $0.00 $157.61
ATA
1HE
SPOT yECoui'm
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:
E. 12.1 zz v41 leywa
L/S ?Coq O S 0 3
Assessor's Tax Parcel Number(s):
Legal Description:
o ppe.4 0,74y P7 4 b ick w v 93 o g 3/c 4 /HA- E,e,
Project Description:
ail Y Z•/l P 1 �lJj
Ai Building Permit
❑ Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
0 Sign
O Tenant (New/Change)
O Other
Depattsuent"UUse Only
❑ Applicant:
Phone:
Fax:
Mailing Address d'Id// ,� / nn
/^ /�//L 5o✓JNt4al eLJJX
J-
Mailing Address:
Dimensions
ay, State, Zip /
Solr-9,‘• GIj C) 9,g0 3 — occ.
Cie,, State, Zip
Miter District/Puryeyoe
°"
0 C�on actor Phone 535lo/g
/410&04" 0pwt .U4O;l Fax ,/¢f' Gr44
`Sewer District/Purveyor
Phone
RUC
Maliaddress
PAM 27/ e riL SiltiAy.tc-
Road width
`
h'
°Setbacks
;Front
'
C
Arghet
'.
School DistrictFire
'•
'"'
'strict
t
.'
Zoning
.,
Left
OWNER/APPLICANT INFORMATION
171 Indicate uba should be (»matted nPasth'ne Ihi✓Drnied
0 Owner:
�t // I (� Phone: 5 Ds %%72
...J/i4b /'Jolctgatyj Fax
❑ Applicant:
Phone:
Fax:
Mailing Address d'Id// ,� / nn
/^ /�//L 5o✓JNt4al eLJJX
J-
Mailing Address:
Dimensions
ay, State, Zip /
Solr-9,‘• GIj C) 9,g0 3 — occ.
Cie,, State, Zip
Finished basement sq. ft.
0 C�on actor Phone 535lo/g
/410&04" 0pwt .U4O;l Fax ,/¢f' Gr44
0 Architect/Engineer
Phone
RUC
Maliaddress
PAM 27/ e riL SiltiAy.tc-
Mailing address
I leat source (electric, gas, etc.)
City, State Zip
5 fl0 L a,,,, £_4J 4 V5-20‘ .6 o/
City, State Zip
WA Stare Contractor licensecA#,/ q&
o//izeO/J/✓/ Z
Contact name:
PROJECT INFORMATION
Building Infortnatiori
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
'Total habitable space
2.`"1 Boor sq. fi.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
I leat source (electric, gas, etc.)
;C :. a
I • -, s a• • s •l li, , ,
irynq ,.
S>grl, V:` . s r.
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year.
Make:
# of signs
Area of existing signs
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /a/a) 0 Yes 0 No
Proposed use
Value
RelOeatton
c.^qy
PirTeale`
,
Previous address
Phone
Fire Sprinkler
Tent
_
Paint booth Fire Alarm
Fireworks display
_
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /a/a) 0 Yes 0 No
Proposed use
Value
.S' pedal llspeepgris Required?
',,,,v,,..0'...1.....',:,..,,, t k
1 Toi(i Re' idexfriaI:Et ergy Cdde Cn ihalit$?
n k=� M a`
Firm Name
What is the current use of this property?
Phone
Will the site be served by a septic system? 0 Ycs 0 No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /a/a) 0 Yes 0 No
Arc critical or hazardous materials used or stored on site?
0 Yes 0 No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there struaures on the property? 0 Yes 0 No
Ifyes, identi on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
Ifyes, identify on site plan 0 Yes 0 No
What is the current use of this property?
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Yes 0 No
Will the site be served by a septic system? 0 Ycs 0 No
Is any part of the property within a 100 yr flood plain?
Ifyer, identify on site plan
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
Ifyes, identify an the site plan 0 Ycs 0 No
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identify on site plan 0 Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /a/a) 0 Yes 0 No
Arc critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a de'signaied Stoi tryatea'CSontrol.Atea? ,
t , , Or.Yes
'
0 No
, Is public sewer available to the-siie?'• '" 0 -Yes t0 No
..
Is. the piopeity.Insidc the ASS\?
"k 140 a ' -
''04 Yes`
0 Yes
0, No
0 »No
Is' public water available to the site? ''0 Yes''' 0 No
b.
a fethe.proplerty inside the PSSA?
la -Yes
r
0 No
Is the property located within 1000 feet of a`Namral Rgsoutce Area?
0 .Yes' 0 Nb - t
Due Received:
Staff Representative:
METHOD OF PAYMENT
❑ CASH ❑ CHECK ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTI IORIZI[1) SIGNATURE:
SUBTOTAL.
TOTAL FEE
MINIMUM PERMIT FEE 15 W e6 P LE ASE
MAKE CI IECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
M,y .v vvd 0 t 6E I
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C07{5"
v el CitO
This site plan, is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
tit
lines/dimensions, curb lines. structures and easements
h Z have been identified. Aar. indicated are wetlands,
bodies of w. r, tee ` f pes or other critical areas. ‘11 Signed: i /... • i?i
h Date: ..
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ADDRESS 4=1 /(21t)c) Va,(l e Xuf
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ROAD WIDTH3°
FRONT E FLANKING
COMMEN ' C
REVIEWED
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