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2005, 08-25 Permit App: 05003054 AdditionProject Number: 05003054 Inv:l Application Date: 08/25/2005 Pagel oft THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information _ _. ...,...� r ., .,,,.,..,.,.. _. ..a .11� --'-' Permit Use: ADDITION TO RESIDENCE Contact: HACKLER, TERRY Address: 10004 E 10TH AVE C - S - Z: SPOKANE, WA 99206 Setbacks: Front Left: 20 Right: 23 Rear 36 Phone: (509) 990-8622 Group Name: Project Name: Site Information: Plat Key: 002704 Name: UNIVERSITY PLACE District: E Parcel Number: 45204.1516 Block: Lot: SiteAddress: 10004 E 10TH AVE Owner: Name: HACKLER, TERRY Address: 10004 E 10TH AVE Location:: CSV SPOKANE VALLEY, WA 99206 Zoning: AGSUB Water District Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Released By: Plan Review Originally Released: 08/25/2005 By: cjjanssen Released By: Originally Released: 08/25/2005 By: TMELBOU Permits: , s _ ... —,.:-s,.-. Rrt. ,__.,.,. ,� . ., Operator: CJJ Printed By: CJJ Print Date: 08/25/2005 Project Number: 05003054 Inv: I Application Date: 08/25/2005 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Permit Contractor: OWNER Description Grp Tvoe Notes RES ADD R-3 VB Item Description RESIDENTIAL PERMIT FEE STATESURCHARGE RESIDENTIAL PLAN REVIEW Notes: Page 2 of 2 Porment Summary: ssr. a,a 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 persons) 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: CJJ Printed By: CJJ Print Date: 08/25/2005 Budding Finn: OWNER Phone: (000) 000-0000 This Application: Total Project: So Ft Valuation Sq Ft Valuation 126 $9,409.68 126 $9,409.68 Totals: 126 $9,409.68 126 $9,409.68 Units Unit Desc Fee Amount 1 SELECT $181.25 1 SELECT $4.50 1 SELECT $72.50 Permit Total Fees: $258.25 Notes: Page 2 of 2 Porment Summary: ssr. a,a 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 persons) 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: CJJ Printed By: CJJ Print Date: 08/25/2005 a I I oUtrUlrvu rai"'II .11110 111 City of Spokane Valley Commmn y Development Depa;,ment Building Division 11707E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 /�thnno• /.RQQI RRR.n0.2R• Far- /SnQI RR8-00.?7 Street Address: 100 0 C? C-- l ©i� 4,- Assessor's Tax Parcel Number(s): 4S w9 - IS / Legal Description: PERMIT DESCRIPTION: Pjd,t -otns t �l�Building Permit F-1Changein Use E] Grading E] Manufactured Home MRelocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNERIAPPLICANT INFORMATION ® Owner.Tr.y, gac�-/e, ❑ Phone: go�0�-"sl�2z Fax: , -675 Address: y32� S S®oku e u a q9z z3 ci stale Zip Code ❑ Contractor. ❑ Phone: Fax: Address city ° slate Zip Code WA State Contractor License Applicant: �^r Phone: Fax: Address: city state Zip Code Architect: Phone: ax: Address: city Stale Lp Code Contact: Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK DIMENSIO S:4 p 10 2 — I`dX?s30; /vX OF STORIES: .S MAIN FLOOR TO SQ. FTG: 2 FLOG SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECKJCOV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITESEPTIC SR q_S SOI W6 ✓Vidth: Length: Manufacturer. Previous Address: Proposed Use _ MANUFACTURED HOME Year. Pit Set: RELOCATION FIRE SAFETY =ire Sprinkler. # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Date/Time: _ ✓aluation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE 'fans Examiner. address: nspector. address: Phone: Phone: SPECIAL INSPECTIONS BOLTING ❑ CONCRETE -Irm Name: nspector(s): Fax: Fax: ❑ REINFORCEMENT ❑ WELDING Phone: Fax: )ISCLAIMER -he permitee verifies, acknowledges and agrees by their signature that: t) If this permit is for construction of or on a (welling, 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 ransaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Werenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley 'ermit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. )wnership of resulting development rights granted by any issued perto the rty owner. 'rint Name erE '. Signature 4ethod of Payment: (Faxed permit applications will only be accepted with major bankcard) ] Cash ❑ Check ❑ Mastercard ;an kcard #: wthorized Signature: Expires: ❑ VISA ❑ Other VIN#: