2002, 08-08 Permit App: 02006787 ResidenceProject Number: 02006787 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
D. t /8/02 Page 1 of 3
Project Information:
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 35 Left: 4 Right: 4 Rear: 15
Site Information:
Plat Key: 002131 Name: RAWLINGS SUB.TR.102.OPP.
Contact: COOK, KEVIN
Address: PO BOX 313
C - S - Z: LIBERTY LAKE WA 99019
Phone: (509) 217-1054
Group Name:
Project Name:
Parcel Number: 45173.0718 Block:
SiteAddress: 410 N WILLOW RD
SPOKANE, WA 99206
Location:: SPO
Lot: 15
District: F
Owner: Name: COOK, KEVIN
Address: PO BOX 313
LIBERTY LAKE WA 99019
Zoning: UR 7
Water District: 011 MODERN Hold: ❑
Area: 21,000 Sq Ft Width: 44
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Special Reviews
oo e/tb-ta4
Approach / Drainage
Landuse/Zoning 4/Q
104—k `-57
y4? c -
LF - 43 I- bI "4'
Depth: 84 Right Of Way (ft): 40
1
Released:
Released By:
Released By: (--,)
SY
Released By: IF
Released By:
Operator: JAS Printed By: JAS
Print Date: 8/8/02
3/6/ -6'2 -
Project Number: 02006787
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for 2-1
commencing work without a permit
Sewer Review / , � 3 «
Date: 8/8/02 Page 2 of 3
Released By:
Permits:
Building Permit
Contractor: DESIGN TEC
Address: P.O. BOX 313
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New
Nbr Of Dwellings:
Bldg W x D: x
Req Parking:
Description
GARAGE
RESIDENCE
glp
U-1
R-3
Firm: KEVIN COOK/DESIGN TEC
Phone: (509) 255-1459
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Type Notes
VN
VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: DESIGN TEC
Address: P.O. BOX 313
LIBERTY LAKE, WA 99019
Item Description
GAS WATER HEATER
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
RANGE
HOOD -TYPE II
Type:
Building Height: Stories:
Sprinklers: LI
Critical Materials: ❑
This Application: Total Project:
Su Ft Valuation Su Ft Valuation
228 $2,736.00 228 $2,736.00
996 $65,736.00 996 $65,736.00
Totals: 1,224 $68,472.00 1,224 $68,472.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$698.75
$4.50
$153.73
$856.98
Firm: KEVIN COOK/DESIGN TEC
Phone: (509) 255-1459
Units Unit Desc
2 NUMBER OF
4 #OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: JAS Printed By: JAS
Permit Total Fees:
Print Date:
Fee Amount
$20.00
$4.00
$30.00
$10.00
$10.00
$10.00
$ 84.00
8/8/02
Project Number: 02006787 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/8/02 Page 3 of 3
Contractor: ROEMER CONSTRUCTION
Address: 5516 E CATALDO AVE
SPOKANE, WA 99212
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER USING DEVICES
Notes:
Plumbing Permit
Firm: ARLEY ROEMER CONSTRUCTIO
Phone: (509) 922-7062
Units Unit Desc
2 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$18.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
$78.00
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$856.98
$84.00
$78.00
$1,018.98
Invoice Amount
$856.98
$84.00
$78.00
$1,018.98
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$856.98
$ 84.00
$78.00
$0.00 $1,018.98
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: JAS Printed By: JAS Print Date: 8/8/02
lik
URI
SpoKANE Cowry
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: At A 10
IAS , l I 0 v.I
Assessor's Tax Parcel Number(s): 4-5173,0-1l0
5I'73rO'7(
Legal Description:
Upi�urf L✓ /
ata 5:s s. b d.v, s. a ..•
at nu et- (aa C¢
,- 15 eiteep £ ao'
Project Description:
eir Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
Department Use Only
Building height to pts` ,
L 4
Phony. 117 f054
Fax: 635 3 9D 1 C.
O Applicant:
.
Water Dixtnc Purvey
O)�
.
Sever Dstrict/Purveyor
Finished basement sq. ft.
,Roadwdth
v
or
-x Setbacks
trent
Left
Rear.
Right
School Dismcr S
//�- /j
v
�(J '.
Fire District 4...L.,
:Zomig
Phone
Fax
a/�'
OWNER/APPLICANT INFORMATION
0 OToner. /
k✓ I .../(Co L'
Building height to pts` ,
L 4
Phony. 117 f054
Fax: 635 3 9D 1 C.
O Applicant:
Phone:
Fm:
Mailing :Address:
Pa. got 3
13
2"1 floor sq. ft.
Finished basement sq. ft.
Mailing Address:
Construction type
Cin, Since, Zip
/16,.> �...t.k
Deck sq. fr.
9901
9
City, State, Tv
0 Contractor
Phone
Fax
0 Architect/Engineer
Phone
Pax
Mailing address
MnT ng address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name
Building Information
Building height to pts` ,
L 4
# of stories
/
Alain floor eq. ft.
.79 `
Unfinished bosernent sq. ft.
Dimcnsitats
36Sc 34..
Total habitable space
19
2"1 floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garay: sq. ft^ ^
Deck sq. fr.
Cost tat project V
Ste ^
,fir I feat source (electric, gas, etc.)
6A 5 re o/
Manufactured Home „ . ,
Sign
Width:
Length:
What is the square footage of the sign
face?
l low high is the sign?
Year.
Make:
# of signs
.Area of assisting signs
Are there slopes greater than 30% on the property? (30 ft ri in 100 6)
( - %) 0 Yes Cf No
Proposed use
Value
Relocation
Fire Safety
Firm Name
Previous address
Phone
Fire Sprinkler
Tent
_
Paint booth Fire Alarm
Fireworks display
_
Are there slopes greater than 30% on the property? (30 ft ri in 100 6)
( - %) 0 Yes Cf No
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
c a N '. G...v
Phone
\\811 the site be served by a septic system? 0 Yes .2 To
Plans Examines
Phone
Inspectors
Is there evidence of 611 or excavation on the property?
0 Yes .0 No
Are there slopes greater than 30% on the property? (30 ft ri in 100 6)
( - %) 0 Yes Cf No
Are critical or hazardous materials used or stored on site?
0 Yes £I'Fo
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes lei lvo
If yes, identify on site plan
What is the current property size?
(square feet or acres) 34, %(62 474
Is any part of the property within 250 feet of a shoreline?
lifts, idents on site plan 0 Yes .12—No✓a
What is the current use of this property?
c a N '. G...v
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes no
\\811 the site be served by a septic system? 0 Yes .2 To
Is any part of the property within a 100 yr flood plain?
Ifyes, idem on site plan
0 Maybe 0 Don't know 0 Yes YJ lvo
Are or will there be wells located on the property?
?yes, identi' on the the plan 0 Yes ,Erno
Are there any wetlands, streams or ponds within 200 feet of the property?
Ilya, idents on site plan 0 Yes BNo
Is there evidence of 611 or excavation on the property?
0 Yes .0 No
Are there slopes greater than 30% on the property? (30 ft ri in 100 6)
( - %) 0 Yes Cf No
Are critical or hazardous materials used or stored on site?
0 Yes £I'Fo
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
O Yes O No
Is public water available to the site? 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?
O Yes O No
Date Received:
Staff Representative:
METHOD OF PAYMENT
V
❑ CASI I ❑ Ci !(CK 0 !EM ❑ -: ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: ' EXPIRES:
HANK(:.\RD NUMBER:
ALM IOlil%I(U SIGN .\'PURI(:
ff77.IC�IIVL''
SUBTOT.\I.
TOTAL FEE
MINIMUM PERMIT FEE ISWCOI'LE SE
ALIKE CHECKS PAVAUI.F. TO SPOKANE
COUNTY PERMIT CENTER
k 4FA colas'
•
"Serving the OPPORTUNITY AREA Since 1905"
N. 904 Pines Road
99206
Telephone (509) 928-4540
Spokane, WA
P.O. Box 14008
99214
E-mail modern@mewco.com FAX # (509) 922-2878
Spokane County
RE: Lot located at approximately 403 N. Willow Ave.
Dear Sir or Madam;
Water service to the lot located at 403 N. Willow Ave. has been stubbed onto the
property. Any residential building built within our Well #4 100' Radius Sanitary Control
Area should not be a concern as long as it is connected to the Sanitary Sewer.
Dave Johnson
Assistant Water Superintendent
45T/J.uvi,
z
0
CNo Septic, DW
or Dryiine
• information
found
dont
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40'
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45173.0701
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20 L.F. 4" SS
45173.0717
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20 LF. 4 SS
45173.0713
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C DATE: REVISED
DRAWING NUMBER