2004, 05-21 Permit App: BLD-04-04409 Addition GarageTHIS IS NOT A PERMIT
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Spokane
Penalties will be assessed for
commencing work without a permit
,;o0VaIley RESIDENTIAL ADDITION/REMODEL
11707 E. Sprague Ave., Suite 106
VALUATION
Spokane Valley, WA 99206
Application #: BLD -04-04409
Job Address: 4125 N WOODLAWN RD
Applied: 05/21/2004
SPOKANE WA99216-2210
Issued:
Description: 392 SO FT GARAGE ADDITION
Expires: 11/17/2004
Subdivision: Lot:
Blk: Parcel No: 45032.0213 Zoning:
Owner: CLARK, RICKY L
FRONT SETBACK
Applicant: CLARK, RICKY L
Phone: (509) 892-7881
Address: 4125 N WOODLAW N RD
REAR SETBACK
SPOKANE, WA 99216-2210
Deposits/Receipts:
Contractor:
Phone:
Address:
Lic No:
General Information:
Fees:
VALUATION
7448
PLAN CHECK FEE
38.31
REROOF
N
BASIC PERMIT FEE
153.25
# OF STORIES
1
WSBCC SURCHARGE
4.50
FRONT SETBACK
EXISTING
Total Calculated:
196.06
REAR SETBACK
74
Deposits/Receipts:
0.00
LEFT SETBACK
N/A
RIGHT SETBACK
5
Total Due:
196.06
OCCUPANCY GROUP
u-1
CONSTRUCTION TYPE
5-n
STRUCTURES ON PROPERTY
1
CURRENT PROPERTY SIZE
80 X 160
SERVED BY SEPTIC SYSTEM
yes
WELLS LOCATED ON PROPERTY
no
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Initials / Date
THIS IS NOT A RECEIPT
Street Address:
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
SITE INFORMATION
Assessors Tax Parcel Number(s): i�'5C�-2 , O2/,3
Legal Description:
PERMIT DESCRIP
❑ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNERIAPPLICANT INFORMATION
�'ddv�vrr 1
Owner: ; /�/'� y,. �'l 1_ Z/&^ IN Applicant: S; max✓
Phone: Tj i-7 is/ Fax: Phone: Fax:
Address: 16 Address:
„1�,
C' State Zip otle CRY Sala Zip Code
❑ Contractor: ❑ Architect:
Phone: Fax: Phone:
Address: Address:
City State Zip Code
WA State Contractor License
Fax:
City State Zip Code
Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS
OF STORIES: /
MAIN FLOOR TO SQ. FTG
2 FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PAT . F G:
OCCUPANgYRO
P:
CONSTRUCTION TYPE:
HEAT SOURC -.
# OF BEDRO S:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJEC :�
0�
6 —
30% SLOPES ON PROPERTY:
SEWER OR ON-SITF, SEPTIC
SYSTEM? Sa c
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
Previous Address:
Proposed Use: _
RELOCATION
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent: Fireworks Display: Blasting:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
Date/rime:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
Phone:
Phone:
SPECIAL INSPECTIONS
Fax:
Fax:
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name:
Inspector(s):
Phone:
Fax:
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 istwill 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 development rights granted by any issued permit inure to the property owner.
Print Name
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard
Bankcard #:
Authorized Signature:
Expires:
❑ VISA ❑ Other
VIN#:
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