2003, 02-10 Permit App: 03000783 AdditionProject Number: 03000783 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/10/2003 Page 1 of 2
Project Information:
Permit Use: RES ADD - ATTACHED CARPORT (12 X 20 X Contact: EKKERT, FEDOR Y & LYUMILA A
9/EXISTING) Address: 4615 E 5TH AVE
C - S - Z: SPOKANE, WA 99212-0373
Setbacks: Front Left: Right: 1 Rear: Phone: (509) 534-8906
Group Name:
Site Information: Project Name:
Plat Key: 000000 Name: UNKNOWN District: D
Parcel Number: 35232.3003
Block: Lot:
SiteAddress: 4615 E 5TH AVE
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District
Area: 1,100.00 Acres
Urban Residential 3.5
Owner: Name: EKKERT, FEDOR Y & LYUMILA
Address: 4615 E 5TH AVE
SPOKANE, WA 99212-0373
Hold: ❑
Width: 60 Depth: 135 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Released
.Released By:
Septic System Review
Released By:
Landuse/Zoning
Permits:
Released By.
Operator: JAS Printed By: JAS
Print Date: 2/10/2003
Project Number: 03000783
Inv: 1
Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/10/2003
Contractor: OWNER
Const Category: Addition
Nbr Of Dwellings:
Bldg W x D:
Req Parking:
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Group:
Occupant Load:
x Building Sq Ft:
Handicap Parking:
Type:
Building Height:
Sprinklers:
Critical Materials:
This Application:
Description Gr Tvpe Notes Sp Ft Valuation
CARPORT U-1 VN 240 $1,080.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Totals: 240 $1,080.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Stories:
Total Project:
Su Ft Valuation
240 $1,080.00
240 $1,080.00
Fee Amount
$38.50
$4.50
$8.47
CONTROL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary:::;;:;;;;::::
Permit Type
Building Permit
$51.47
Fee Amount Invoice Amount Amount Paid Amount Owing
$51.47 $51.47
$0.00 $51.47
$51.47 $51.47 $0.00 $51.47
Page 2 of 2
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: 2/10/2003
SPOKANE COUNTY
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:
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: —(\O rte Cra-69c4'
4 11 cnotXl Cn5ivutk i
❑ Building Permit
❑ Change in Use
❑ Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
Depaiiinent Use Only
Phone:5Y1 ggbC.
Fax:
0 Applicant:
Phone:
Fax:
Marling Address:
tills `
.Wate'District/Paneyor
Sewer District/Purveyor
^"
Road width
Setbacks
'Prone
Left
o'
e
,Rea w
R'gh
'
"
School District "'
Fire District
Zonings
-
OWNER/APPLICANT INFORMATION
El Indicate who .rbadd be contacted reeardine ibis pried
0 Owner. (
Pyr KKK `y
Phone:5Y1 ggbC.
Fax:
0 Applicant:
Phone:
Fax:
Marling Address:
tills `
1CJ2
Mailing Address:
2# Floor sq. ft.
Cite, State, Zip
S7.0Ka-ne) �1n
Q4Vt
City, State, Zip
Garage sq. ft.
0 Contractor
arce.c
Phone
Fax
0 Architect/Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
PRO IECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2# Floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
1-leat source (electric, gins, etc.)
Manufactured Horne, , . , ",
Sign"
Width:
Length:
What is the square foogge of tllck.sign
face?
I low high is the sign?
Year.
Make:
# of signs
Area of existing signs
_
Proposed use
Value
Relocato>?r, �u
dire Safety
. ,,
Firm Name
Previous address
Phone
Fire Sprinkler
Tent
Paint booth _ Fire Alarm
_
Fireworks display
Is there evidence of fill or excavation on the property? /
0 Yes LY No
_
Proposed use
Value
.Special Trip? eelione Requlred? S "9
:Non- Ff i 3entt�l; Energy. ode' . oin liarnce?
Firm Name
What is the current use of this property?
Phone
Plans Examiner~
Phone
Inspectors:
Are there any wetlands, streams or ponds within 201,0 feet of the property?
Ifyes, identify all siteplan 0 Ycs ID No
Is there evidence of fill or excavation on the property? /
0 Yes LY No
Are there slopes greater than 30% on the property? (30 ct rise in 100 ft)
( /n/o) 0 Ycs El No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? Yes O No
Iyer, identify on site plan
What is the current property size?
(square feet or acres)
Ts any part of the property within 250 feet of a sho line?
lips, identify on site plan 0 Yes 21 No
What is the current use of this property?
Is your property in a signated wildlife habitat arca?
Don't know 0 Ycs 0 No
,,(�
Will the site be served by a septic system?F7 Yes 0 No
Is any part of the property within a 100 yr flood plain?
Ifyes, iden0 on site pity,/
0 Maybe H Don't know 0 Yes 0 No
Are or will there be wells located on the property? /
Ifyes, Menhir on the site plan 0 Yes No
Are there any wetlands, streams or ponds within 201,0 feet of the property?
Ifyes, identify all siteplan 0 Ycs ID No
Is there evidence of fill or excavation on the property? /
0 Yes LY No
Are there slopes greater than 30% on the property? (30 ct rise in 100 ft)
( /n/o) 0 Ycs El No
Are critical or hazardous materials used or stored on site?
_ 0 YesIC No
DEPARTMENT USE ONLY
Is the pi'6pert3cin a dSigtiated Storhlwatt?Control Area? ' `
, II ebbic"sewelayailsble'to'the site? 0 Yes 0 No
, n
^Is
Is`the property inside the ASA? ` -^
s
°"
`t"
,0 Yes. 0 4No
:0=''Y€s .a, O Nd. .
Public water available to the site? 0 Yes 0 No
Is the froperty'inSide the PSSA?: '
.,r " ,z ; s .`' '+.
'
''
.
a S.es 0 PNd
is the property 'Ideated within 1000 feet of a Natural Resource Area?
0' Yes 0 ^No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
0 CASH 0 CHECK ❑ A
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $SS W PLEASE
PLAICE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
I
N
LOT 10, AND
WEST 10 FEET
OF LOT 11,
BLOCK 1,
CARNHOPE ADD
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LO
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12
2
1000 GALS
I0
5
SCALE 1=20
36
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