2009, 07-28 Permit App: 09001920 Roof Repair Proje s.t Number: 09001920 Inv: 1 Application Date: 7/28/2009 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: REPAIR SNOW DAMAGED ROOF Contact: FAIRWAY RESTORATION
Address: 1620 N MAMER
C-S-Z: SPOKANE VALLEY WA 99216
Setbacks:Front Left: Right: Rear: Phone: (509)244-4445
Group Name:
Project Name:
Site Information:
rte:: , :.- r -1
Plat Key: Name: Range District: East
Parcel Number: 55202.0192 Block: Lot:
SiteAddress: 19003 E 4TH AVE Owner:Name: PARKER,LISA F
Address: 19003 E 4TH AVE
Location::CSV GREENACRES,WA 99016
Zoning: R-3 SF Res District
Water District: Hold: ❑
Area: 32,020 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: 4.... .. : , .> . : . -... . .r .. .,
Review
Building Plan Review
Released By:
Originally Released: 6/29/2009 By: tmelbourn
Building Permit
Contractor: MJ TAKASAKI/FAIRWAY REST. Firm: MJ TAKASAKI/FAIRWAY REST.
Address: 1620 N MAMER Phone: (509)244-4445
SPOKANE VALLEY WA 99216
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB ROOF 0 $10,000.00 0 $10,000.00
REPAIR
Totals: 0 $10,000.00 0 $10,000.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $181.25
WSBCC SURCHARGE 1 SELECT $4.50
SF PLNS RVW<7999 SQ FT 1 SELECT $72.50
Permit Total Fees: $258.25
Operator: JD Printed By: jmm Print Date: 7/28/2009
Proje st Number: 09001920 Inv: 1 Application Date: 7/28/2009 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: .. .. . ._. "'41sivewa.AragiScre‘44454.V/NE..-nraWI, MW-"VeleleMIMY4WINAP,MORKVX1W,SWe .44 ,,,10"
Payment Summary: ": ;: ',I, ,V' .Z
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $258.25 $258.25 $0.00 $258.25
$258.25 $258.25 $0.00 $258.25
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: JD Printed By: jmm Print Date: 7/28/2009
Permit Center I
Spokane 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: 7��
ti Spokane Valley,WA 99206 PERMIT FEE:
'Valley- (509)688-0036 FAX:(509)688-0037
www.spokanevalley.org
Community Development
Residential Construction New Construction n Accessory Bldg
Permit Application n Addition/Remodel Deck
n Other:
SITE ADDRESS: 9VO
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building Owner:_ Contractor:
Name: Name:
Address. \913()23 Address: (02.b
Qx---
City: O1, „Q \1„ ( ,State: W Zip: Q C City:C � �/ State: Zi ?�F
Phone: _��Ci - 1 Phone:!_�eZ`*��1 'q'"1 Fax:
Coo�rractor Lic No: Exp Date:
/►IJ TAK1..704IZ3C P
Contact Person City Business Lic.No:
Name: C \( \)L)( ,111,1r\awl-uf
Phone: 2t+-1
Describe the scope of work in detail: Cost of Project: $ )() 60b
13/4./e3V.',C� (Ari r - c 0a 00.A
Proposed Use:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES: TOTAL HABITABLE SPACE:
MAIN FLOOR TO Se. g a•: Q. FTG: UNFI , ENT SQ. FTG: IMPERVIOUS SURFACE
FTG: 1111111 AREA:
FINISHED BASEMENT GARAGE'�Q. FTG: DECK/COV. PATIO Sa. - _ 30% SLOPES ON
SQ. FTG: RN:
#OF BEDROOMS: CONSTRIIJCTION TYPE: HEAT SOURCE: SEWER OR`SERTIC?
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE: DATE:
Method of Payment: REGD::14"i ED BY
❑ Cash 0 Check ❑ Mastercard 0 VISACITY c C _i. v'AI LEY
Bankcard#: Expires: VIN#:
Authorized Signature:
REVISED 2/15/07 {-'Gr7rVi'' `s-i'S
RESIDENTIAL CHECK LIST DIRECTIONS: r },
Place a check mark in box next to each document required for complete submittal.
o SITE PLAN
o Property lines and dimensions o Setbacks to property lines
o Direction arrow pointing North and orientation to streets o Distance between buildings
o Proposed/existing buildings (footprint and dimensions) o Right of way/easement location & sizes
o Utilities, septic tank/drain field locations and distances o Driveway approach size and location
BUILDING PLANS (3 SETS) (minimum 1/8 inch scale or completely dimensioned)
❑ Elevations (Front/Rear/Sides)with roof peak and wall height including basement:
❑ Foundation Plan (crawlspace, basement or slab on grade):
o Footing sizes and locations o Supporting wood cripple walls or beams
❑ Perimeter concrete foundation wall sizes o Thickened concrete pads supporting
o Crawlspace ventilation beams or girder trusses
❑ Floor Plan of each level (finished or unfinished)with dimensions:
o Floor Joist direction, size and spacing o Window and door location and sizes
❑ Header, beam or concrete lintel sizes ❑Window well locations if applicable
o Brace wall panel locations o Room usage labels
o Water heater and furnace locations ❑ Smoke detector locations
o Exhaust fan locations o Attic and crawl space access locations
o Deck or concrete patio sizes and locations 0 Fire Wall construction
❑ Roof Plan:
o Engineered truss direction and spacing o Ridge, eave and valley lines
o Rafter and over frame direction, size and spacing o Beam and girder size and location
❑ Wall Section Detail including:
Roof
o Slope/roofing material/underlayment/ice dam protection ❑ Truss or rafter size, spacing &connection
❑ Sheathing size and type o Attic insulation/air space baffle/ventilation
Ceiling
o Joist size and spacing o Size of ceiling gypsum wall board
Wall
o Height/top plate/stud size and spacing/sole plate ❑ Siding/exterior house wrap/anchor bolts
o Exterior sheathing size and type ❑ Insulation, vapor barrier, gypsum wall board
Floor
o Joist size and spacing o Sheathing or concrete floor size/insulation
Foundation Wall
o Concrete or Masonry unit width o Footing bottom to finished ground level depth
❑ Earth to wood separation distance ❑ Horizontal &vertical reinforcement if any
Footing
o Size o Reinforcement if any
Radon
o Passive system with 6mil vapor barrier o Active system with 6 mil vapor barrier
Miscellaneous Construction Details
❑ Deck:
o Floor plan/side view/dimensions ❑ Footings/post/and beam size and locations
o Floor Joist/decking direction, size and spacing
O Stairway tread rise & run and nosing 0 Handrail/Guard height &spacing
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General/Specialty Contractor
A business registered as a construction contractor with LEtI to
perform construction work within the scope of its specialty. A
General or Specialty construction Contractor must maintain a surety
bond or assignment of account and carry general liability insurance.
Business and Licensing Information
Verify Workers' Comp Check for Dept. of Revenue Account
Premium Status
Name M J TAKISAKI UBI No. 601029413
INC
Phone No. (206) 324- Status ACTIVE
444Address 1312 S License No. MJTAKI*123CA
WELLER ST
Suite/Apt. License CONSTRUCTION
Type 24 CONTRACTOR
City SEATTLE Effective 2/1/1988
Date
State WA Expiration 9/26/2009
Date
Zip 981442051 Suspend
Date
County KING Specialty 1 GENERAL
Business Corporation Specialty 2 UNUSED
Type
Parent
Company
Other Associated Licenses
License Name Type Specialty Specialty Effective Expiration Status
1 2 Date Date
PINE ISLAND CONSTRUCTION
PINEICI987K1 CONSTRUCTION CONTRACTOR GENERAL UNUSED 5/21/2002 5/21/2010 ACTIVE
INC
M J CONSTRUCTION
MJCONI*134BM CONSTRUCTION CONTRACTOR GENERAL UNUSED 1/14/19878/28/1988ARCHIVED
INC
M J CONSTRUCTION
MJCONC`154N8 CONSTRUCTION CONTSRARCTOR GENERAL UNUSED 8/28/1985 8/28/1987 ARCHIVED
CO
httns://fortress.wa.aov/lni/bbin/Detail.asnx 6/29/2009
Look Up a Contractor, Electrician, Plumber or Elevator Professi... Page 2 of 2
•
Business Owner Information s Hide All
Name Role Effective Date Expiration Date
TAKISAKI, MARK J 01/01/1980
TAKISAKI, CATHERINE A 01/01/1980
a Bond Information I)
Bond Bond Effective Expiration Cancel Impaired Bond Received
Bond Company Account Date Date Date Date Amount Date
Name Number
5 HARTFORD 52BSBAY131908/27/2004Until
CAS INS CO Cancelled $12,000.00 08/02/2004
4 CONTINENTAL007033825 08/28/2001 Until 08/28/2004
CAS CO Cancelled $12,000.00 08/23/2001
rs Insurance Information jd
Insurance Company policy Number Effective Expiration Cancel Impaired Amount Received
Name Date Date Date Date Date
LIBERTY
22 SURPLUS DGLSF184640045 12/01/2008 12/01/2009 $1,000,000.00 12/08/2008
INS CORP
LIBERTY
21 SURPLUS DGLSF1846400 12/01/200712/01/2009 $1,000,000.0011/25/2008
INS CORP
LIBERTY
20 SURPLUS DGKSF184600 12/01/200512/01/2007 $1,000,000.00 12/07/2006
INS CORP
CLARENDON
19 AMERICA FMFL000293 12/01/200412/01/2006 $1,000,000.0011/14/2005
INS CO
CLARENDON
18 AMERICAN Q000043302 12/01/200312/01/2004 $1,000,000.0012/09/2003
INS CO
CLARENDON
17 AMERICA HML0002506 12/01/200212/01/2003 $1,000,000.0001/23/2003
INS CO
LIBERTY
16 NORTHWESTCOA000124501 09/18/200109/18/2003 $1,000,000.0009/23/2002
INS CORP
AETNA Until
2 CASUALTY Et 81C0127848 08/28/1987 Cancelled
SURETY
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MID s://fortress.wa.aov/lni/bbin/Detail.asnx 6/29/2009