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2001, 09-12 Permit App: 01007822 Addition . . „ Project Number: 01007822 Inv: 1 Application Date: 9/12/2001 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: LIVING ROOM ADDITION TO RESIDENCE Contact: ARLEY ROEMER CONSTRUCTION Address: 16116 E KAHLUA LN C -S -Z: MICA,WA 99023 Setbacks: Front 34 Left: 19 Right: 12 Rear: EX Phone: (509)999-9878 Group Name: Site Information: Project Name: Plat Key: 001840 Name: OPP.TR 1-354 District: Parcel Number: 45222.1019 Block: Lot: SiteAddress: 12819 E 6TH AVE Owner:Name: BELTON,DONALD SPOKANE,WA 99216 Address: 12819 E 6TH AVE Location::SPO SPOKANE,WA 99216 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: Area: 0 Sq Ft Width: 70 Depth: 315 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Department Review BUILDING Site Plan Review Released By' '1191' Hold Reasons: gt_le' . - Permit Conditions: — C 0 g BUILDING Plan Review Released BY: - -- Hold Reasons: Permit Conditions: Project Number: 01007822 Inv: 1 Application Date: 9/12/2001 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: ROEMER CONSTRUCTION Firm: ARLEY ROEMER CONSTRUCTIO Address: 5516 E CATALDO AVE Phone: (509)999-9878 SPOKANE,WA 99212 Building Characteristics Const Category: Addition Group: R-3 Type: VN Nbr Of Dwellings: 1 Occupant Load: 0 Building Height: 15 Stories: 1 Bldg W x D: 8 x 23 Building Sq Ft: 184 Sprinklers: Req Parking: 0 Handicap Parking: 0 Critical Materials: E This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation RES ADD R-3 VN 184 $11,408.00 184 $11,408.00 Totals: 184 $11,408.00 184 $11,408.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $188.00 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $41.36 Permit Total Fees: $233.86 Payment Summary: . . ... Operator: RMB Printed By: RMB Print Date: 9/12/2001 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $233.86 $233.86 $0.00 $233.86 $233.86 $233.86 $0.00 $233.86 ...................................................................................................................................... . , . , ., ,/..f.„ a ,___,---38,6 j i PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT Aitiilik 1026 WEST BROADWAY AVENUE SPOKANE,WA 99261 SPO GD509-477-3675 cI l SPECIFIC SITE INFORMATION Street Address: Assessor's Tax Parcel Number(s): i �. . X.1 /©(V Legal Description: rel Project Description: , (5-11 Uva wilding Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit ❑ Relocation ❑ Sign ❑ Tenant(New/Change) ❑ Other Department Use Only Water District/Purveyor. Sewer District/Purveyor Road width Setbacks. Front Rear: School District Fire District: Zoning n LLeft: Right: OWNER/APPLICANT INFORMATION El lndicale who should he ronladed rrtardin1/lbicptojerl ❑ )canner: /] Phone: In :App11cant Phone: Vy6 /fe L lfcrrr- Fax: I:as: Mailing Address: Mailing Address: City,State,tip (ate,State,tip IACjPhonc PhoneEl Co�actor gqr916-7 O— Architect:Iinb,ineer O am -e",-- (7,-1---„,s I a. Fax Mailing address Mailing address (:it,,State tip Cin,State'/.ij WA State Contractor license# Contact name: PROJECT INFORMATION Building Information Building height to peak #of stories Main Boor sq.ft. Unfinished basement sq.ft. /S' / Dimensions Total habitable space 2"d floor sq. ft. Finished basement sq.ft. Ewa 3 lei Occupancy group Construction tc c Garage sy.ft. Deck sq.ft. Cost of project I Icat source(electric,gas,etc.) /p)/Do 0 e(- a Manufactured Home Sign Width: Length: What is the square footage of the sign flow 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 O Concrete 0 Welding 0 Bolting 0 Reinforcement , Address ADDITIONAL SITE INFORMATION Arc there structures on the property? O Yes 0 No What is the current property size? I fyer,identify on site plan (square feet or acres) Is any part of the property within 250 feet of a shoreline? What is the current use of this property? Ifyes,idem ,on site plan 0 Yes 0 No Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes 0 No 0 Don't know 0 Yes 0 No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? 1 fye.r,identify on site plan ident61 identifyon the site plan 0 Yes 0 No 0 Maybe 0 Don't know 0 Yes 0 No Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property? _Eyes,identr y on site plan 0 Yes 0 No 0 Yes 0 No Are there slopes greater than 30°,',on rhe property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site? ( o,/o) 0 Yes 0 No 0 Yes 0 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No 0 Yes 0 No Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No 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? 0 Yes 0 No Date Received: Staff Representative: METHOD OF PAYMENT VISA -:, JCSV. ;;UBTO'l':A]. ❑ CAslI ❑ :HICK ❑ ❑ ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD I:NPIRI{S: TOTAL FEE MINIMUM PERMIT FEE IS 535.00 B.ANkC.ARD NUMBER: PLEASE MAKE C,I-IECKSPAYABLE TO SPOKANE COUNTY PERMIT(:ENTER U l l lORl/.I'.D SI(;N:Vl URl:: . v t — Customer Approval Special Instructions ee174( Sold By /?e /q e, a---- Delivery Date ' r e (/ it 4-5 1'19 PLAN NO. i , , l l , 7i { I�10fv i�rt e This site plan is beir g submitted for the purpose of s obtaining a building permit and is a true and correct representation of the proposal.All known property j lines/dimensions,curb lines. structures and easements Vi.)119 have been identi ed. ,o indicated are wetlands, ADDPESbodies of wa , slopes or other critical areas. ZONEa) i i ' ROAD WIDTH 54 Signed: FRONT FLANKING Date: il/P/at . COMME , — REVIEWED B''a : ... -- , yw t. i ! ry • • / %��� / �a i .. t. J / 1 Q I tr v 34' i I i Q O s : 6 (� /'��Lx to I' 4:` :1 . . ©1998 White Consolidated Industries, Inc., Printed in U.S.A. , We have excluded all cabinets not listed on this she