2004, 12-02 Permit App: 04009280 Finish Basement Project Number: 04009280 Inv: 1 Application Date: 12/02/2004 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH BASEMENT-FAMILY ROOM& Contact: JIM CAMERON
BEDROOM Address: PO BOX 744
C-S -Z: NEWMAN LAKE WA 99025
Setbacks: Front Left: Right: Rear: Phone: (509)768-2144
Group Name:
Site Information: Project Name:
Plat Key: 005751 Name: PARC CENTRE District: F
Parcel Number: 45213.9284 Block: Lot:
SiteAddress: 11010 E 11TH LN Owner: Name: BUCKHOLDT,WILLIAM&KIMB
Address: 11010 E 11TH AVE
Location::CSV SPOKANE VALLEY,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
•
Water District Hold: ❑
Area: 1,179.00 Acres Width: 77 Depth: 120 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
(1_, r2 tt-
Building Permit
Contractor: B-LINE CONSTR& Firm: B-LINE CONSTR&REMODELIN
Address: PO BOX 744 Phone: (509)768-2144
NEWMAN LAKE WA 99025
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT R R-3 VB BASEMENT 840 $4,200.00 840 $4,200.00
FINISH
Totals: 840 $4,200.00 840 $4,200.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $111.25
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $44.50
Permit Total Fees: $160.25
Operator: K_C Printed By: K_C Print Date: 12/02/2004
Project Number: 04009280 Inv: / r Application Date: 12/02/2004 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
OK TO ISSUE SEWER PERMITS PER BILLY 6/30/98
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $160.25 $160.25 $0.00 $160.25
$160.25 $160.25 $0.00 $160.25
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: KS Printed By: K_C Print Date: 12/02/2004
i, . f
BUILDING PERMIT APPLICATION WORKSHEET
San'of City of Spokane Valley Community Development Department
kane Building Division
11707 E. Sprague Avenue, Suite 106
4, alaV p
V g
Spokane Valley, WA 99206
J Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 1 /O j C� E // ,ti 5,x 44-vi e - (A//
Assessor's Tax Parcel Number(s):
Legal Description:
•PERMIT DESCRIPTION: T3CV \* I,1,t.31 ~— 0 $-e/YA 4- 'la.LL, d_H,NA_
L Building Permit ❑ Change in se ❑ Grading ❑ Manufactured Home
n Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: 3U.(Alidf I0 L-rr( t q-4,4449Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
(l Contractor: 5-Lin f Architect:
Phone: 7(,g>2.iyq Fax: Phone: Fax:
Address: pO & )( 71./N Address:
Newcm 4e-) £I GA 95zkS
City State Zip Code City State Zip Code
WA State Contractor License #: 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. PATIO SQ. FTG:
OCCUPANCY GR'VP CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
II RELOCATION
-
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax: _
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
Inspector(s):
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 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.
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 ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: