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2002, 10-08 Permit App: 02008840 Garage Project Number: 02008840 Inv: I Application Date: 10/8/2002 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 30 GARAGE ADDITION Contact: BLACKWATER CONSTRUCTION Address: 816 ARIZONA ST C-S -Z: RATHDRUM,ID 83858 Setbacks: Front 33 Left: EX Right: 11 Rear: 20+ Phone: (208) 687-6916 Group Name: Project Name: Site Information: Plat Key: 002849 Name: WELLESLEY MANOR 3RD ADD District: H Parcel Number: 46363.0119 Block: Lot: SiteAddress: 16019 E WELLESLEY AVE Owner: Name: CAREY,BEVERLEY SPOKANE,WA 99216 Address: 16019 E WELLESLEY AVE Location::SPO SPOKANE,WA 99216 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 13,056 Sq Ft Width: 96 Depth: 136 Right Of Way(ft): 60 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Nan Review • Released By: it < 1C� Plan Review Released = � g C) Operator: RMB Printed By: RMB Print Date: 10/8/2002 Project Number: 02008840 Inv: 1 Application Date: 10/8/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: BLACKWATER CONSTRUCTION Firm: BLACKWATER CONSTRUCTION Address: 816 ARIZONA ST Phone: (208)687-6916 RATHDRUM,ID 83858 Building Characteristics Const Category: Addition Group: Type: Nbr Of Dwellings: Occupant Load: Building Height: Stories: Bldg W x D: x Building Sq Ft: Sprinklers: ❑ Req Parking: Handicap Parking: Critical Materials: ❑ This Application: Total Project: Description Grp Type Notes Su Ft Valuation Sq Ft Valuation GARAGE U-1 VN 720 $8,640.00 720 $8,640.00 Totals: 720 $8,640.00 720 $8,640.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $150.50 STA l'E SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $33.11 Permit Total Fees: $188.11 Notes: Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $188.11 $188.11 $0.00 $188.11 $188.11 $188.11 $0.00 $188.11 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: 10/8/2002 I I PROJECT APPLICATION WORK SHEET It SPOKANE COUNTY DIVISION OF BUILDING &CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE,WA 99260 SPOK IIV COUNFY 509-I77-3675 SPECIFIC SITE INFORMATION Street Address: /,7: 40/ C. id d Sp6k� , 04-5d- Assessor's Tax Parcel Number(s): ; (� „ p' Legal Description: `� tC t(U l� Project Description: C}A--01-6-L dJ 1 /tA, LSI Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit ❑ Relocation ❑ Sign El Tenant(New/Change) ❑ Other Department Use Only Water District/Purveyor Sewer District/Purveyor Road width Q , Setbacks Front: Rear: School District: Fire District: Zonal fff...3 LSLeft: Right: OWNER/APPLICANT INFORMATION 0 /ndhalr ni's ahunlrl is rrm61rhal ngurrlinIll,PrTLYI (Toner Phone. 507-9A/ /,j 3 El :APPhcanr. Phone: cee-k/e,E fl v e,,,,,x, I:,.: I ax Haling.\dJrexs: Slaihni:\ddre,: /6C/f C, I eUie / t.itr,State,/iP Cit,,State,tip rP©kove , d 17 bra 6 2 LUI tractor Phone ❑ \rchrteet.I.n�>tneer 8(A-dtPhone c)i t l Comte C /v 2i/t' ii"ax (�f4f/4N I aX Mailing address Haling address '314 AziIr4A- 4 CSate tip tat,,Marc tip \\iilfi—SAL/2ukf J ��ir� 83E5-8 State Contractor license= Contact name: PROJECT INFORMATION Building Information Building height to peak #of stories Mam floor sq. It. Unfinished basement sq. ft. �r Dimcnsionc Total habitable space 2"floor sy. ft- finished basement sq. tt. NI g /X SOS )ccupancc ge:mp (:rmstructton type Garage sq. ft. Deck Sc].ft. (.ost of project I Icat source U.lectne,gas,etc Manufactured Home , Width: Length: What is the square footage of the sigm I lose 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 D Concrete O Welding D Bolting o Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? D Yes D No What is the current property size? If yes,identi6-on cite p/an (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,identf'orsite plan D Yes D No Is your property in a designated wildlife habitat area? Will the site be served by a septic system?D Yes D No )(s D Don't know D Yes D No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? //yes,identify on site planJ 1/Jess identi6,on the site plan D Yes D No D Maybe D Don't know D Yes LN 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.identify on site p/an D Yes D No D Yes D No Are there slopes greater than 30"'s on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site? o Yes D No O Yes D No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? Is public sewer available to the site? D Yes D No DYes ONo Is the property inside the ASA? D Yes D No Is public water available to the site? D Yes D No D Yes D No Is the property inside the PSSA? D Yes D No Is the property located within 1000 feet of a Natural Resource Area? Cl Yes 0 N Date Reccicrd: Staff Represcntat ice METHOD OF PAYMENT COVE; SUBTOTAL VISA ❑ ( \Sl l ❑ ca lld;K D ❑ ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DV]l(: ICSPIRI:s: TOTAL FEE B.ANRC\RD NU\IBI'.R: MINIMUM PERMIT FEE IS 5..35.00 PLEASE MAKE CHECKS P li',t3LE TO SPOT,UE Il IORI/.I'.I)',l(iNA I LIRIi: <OUNT PERM]]]] TER k Yhis c'/r:+.n`k �*irin/bmittedfor the purpose of uotamnyaku,|c/o5po/vb6odisotrue and correct reprentation of the preposaL AU known property Iines/dImenons,curb nes,structures and easements have been idenU�od A|koind�a�d�ewetlands, x�/ / bodies ufwotnc tnnp ^ xp, m,n/ p �u, � Signed: �� ~/ »�i'6 " --� ,--\,k- ~~ � / Date. ' 111� C� � // L��^�\ ,���(�s , �� ^ ' ZONE ]�m� J _ .�/ m� ROAD / —y � FR{}NT ' � ! NK]NG � � �_ CL)��i�E�T� — RENEV�EO ~ • ^ ( --�/ ^ � { | �, � " ' ^' ! `\ -.(' � -___-___ _�'___~ L ' @3„.9.....„ . 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