2005, 06-06 Permit App: 05001919 Pole Bldg Project Number: 05001919 Inv: 1 Application Date: 06/06/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 40 X 24 POLE BUILDING Contact: MICHLIG,JON
Address: 616 N VISTA RD
C-S-Z: SPOKANE VALLEY,WA 99212
Setbacks: Front 200 Left: 5 Right: 10+ Rear: 5 Phone: (509)954-0295
Group Name:
Site Information: Project Name:
Plat Key: CONY Name: CONVERTED CNTY DATA District: Nort
Parcel Number: 45184.0415 Block: Lot:
SiteAddress: 616 N VISTA RD Owner:Name: MICHLIG,JON
Address: 616 N VISTA RD
Location::CSV SPOKANE VALLEY,WA 99212
Zoning: AGSUB
Water District: Hold: ❑
Area: ;,000.00 Acres Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 10
Review Information:
Review
Site Plan Review Released By: ' 'Ail LI- „. la
Lk,*
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Plan Review Released By: if AA ()\ ti(
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Septic System Review Released By: C A. il� +`,
Permits:
Operator: K_C Printed By: K_C Print Date: 06/06/2005
Project Number: 05001919 Inv: 1 Application Date: 06/06/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Finn: OWNER
Phone: (000)000-0000
Building Characteristics
Group: U-1 Type: VB
Total Area 960
Building Height 14
Stories
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Su Ft Valuation
GARAGE U-1 VB 960 $18,240.00 960 $18,240.00
Totals: 960 $18,240.00 960 $18,240.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $307.25
STATE SURCHARGE 1 SELECT $4.50
Permit Total Fees: $311.75
Notes: ,
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $311.75 $311.75 $0.00 $311.75
$311.75 $311.75 $0.00 $311.75
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: K_C Printed By: K_C Print Date: 06/06/2005
06/03/2005 15:07 5093241567 SRHD EHS PAGE 01/01
JUN lai eum 1b:14 t-K TO 3241567 P.01/02
• . 3UILDI;i4G PERMIT APPLICATION WORKSHEET
S�' City of S Dane Valley Community Development Department
Sp 1 , i 1 1 (� q &!Icling Division
11707 E. Sprague Ave,�ue, Suite 108
deovall
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1 Spokane Valley, WA 99206
j ''' li 3 t, 'ThPhcone: (509) 888.0036;Fax: (30V} 688-0037
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Pt `-' I ' ITE:INFORMATION
CI /V V'
etre®t Address: i'4- i
Assessors Tax Parcel Number(s): 40% g
Legal Description: I
PERMIT DESCRIPTION: �a1 LII fo IP Lovi1e8 i'iq
Building Permit Oil Change in Use 0 Grading 0 Manufacs;ured Home
Relocation u Tenant Improvement (3 Fire Safety ❑ Other
,..=...L.................
OWNER/APPLICANT INFORMATION I
l
1 .. Ov►ner. .0%ht .❑ ; Applicant ;g •
A"Phone: t59• . 1' Fax: Phone: FacION
Address: G u. fr. Ut)t.L Address: ..
�.t� S INA"; LAIib
tat.It. 1,1.
w City , std. ap Code ., Stab Zip Code
Contractor 219:et / 'Architect _
Phone: Fax: Phone: Fay;_
Address: Address: _
City Slate Zip Code 1 City Stats Zip Cods
• WA State Contractor License#:•� Galled: i �►,,/f-- , -,. - G�(o'
Spokane Valley Bus. Liscense#: Contact b�ii.i
12�0
i PERMIT/BUIL N IIII
�
RMATION ,(-
7 .
HEIGihT TO PEAK: ,DIMENSIONS: - '''rf OF STORIES:
ty, 7, fid. O' \_ .�
MAIN FLOOR T$6Q.FTG: 2"1'FLOOR SQ. (3: I UNPIN -+•'," - ,1
F1 ISHED BASEMENT SQ.FIG: QARAGa SQ.FIG: DECK/COV.PATIO SCI.TTG:
OCCUPANCY GROUP: C•1 STRUCT1ON T(PE: KAT SOURCE:
#OF BEDROOMS: TOTAL HATIWSI SPACE: IMPERVIOUS SURFACE AREA
OS •F PR JE : 30%S •' ON PROPERTY:I SEWER OR ONS l.4➢I.
1111 291 . t Na__ i SYSTEM?
1
JUN 03 2005 16:17 5093241567 PAGE.01
MANUFACTURED HOME
•
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
Inspector(s):
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting)01(k
development rights granted by any issued permit inure to the property owner.
Print Name tit iCvkl' Signature SOO
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash 0 Check 0 Mastercard 0 VISA 0 Other
Bankcard#: Expires: VIN#:
Authorized Signature:
eri 0:
This site plan is being submitted for the purpose of L'
obtaining a building permit and is a true and correct `'
representation of the proposal. All known property � .-.- S
lines/dimensions,curb lines,structures and easements
have been identified. Also indicated are wetlands,
bodies of water, steep slopes or other critical areas.
Signed
Date:
Id.
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