2003, 02-04 Permit App: 03000673 Garage Project Number: 03000673 Inv: 1 Application Date: 2/4/2003 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 30 X 33 DETACHED GARAGE W/ROUGH IN Contact: DAVIS,MARK
BATHROOM Address: PO BOX 3965
C - S -Z: SPOKANE,WA 99220
Setbacks: Front 35 Left: 5 Right: 5 Rear: 20+ Phone: (509)622-3557
Group Name:
Site Information: Project Name:
Plat Key: CONY Name: A District: D
Parcel Number: 35244.1401 Block: /181. Lot:Qs
SiteAddress: 7124 E 12TH AVE Owner: Name: DAVIS,MARK
SPOKANE,WA 99212 Address: PO BOX 3965
Location::SPO SPOKANE,WA 99220
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 5,400 Sq Ft Width: 40 Depth: 135 Right Of Way(ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: l
Review Information:
Review
Site Plan Review Released By: 0 K. Ref c,,ke
Plan Review
Released By: VV 3
Approach/Drainage
Released By: s.
Sewer Review Released By.
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Operator: RMB Printed By: JAS Print Date: 2/4/2003
Project Number: 03000673 Inv: 1 Application Date: 2/4/2003 Page 2 of 3
THIS IS N&T A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Firm: OWNER
Phone:
Building Characteristics
Const Category: New Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: Li
This Application: Total Project:
Description Grp Type Notes So Ft Valuation So Ft Valuation
GARAGE U-1 VN 990 $11,880.00 990 $11,880.00
Totals: 990 $11,880.00 990 $11,880.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $188.00
STATE SURCHARGE I Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $41.36
Permit Total Fees: $233.86
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone:
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 1 NUMBER OF $6.00
SINKS 1 NUMBER OF $6.00
ELECTRIC HOT WATER TANK 1 NUMBER OF $6.00
MINIMUM FEE ADJUSTMENT 1 Select $17.00
Permit Total Fees: $35.00
Operator: RMB Printed By: JAS Print Date: 2/4/2003
Project Number: 03000673 Inv: 1 Applicationg
Date: 2/4/2003 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
CONTOL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary: :: .:.....
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $233.86 $233.86 $0.00 $233.86
Plumbing Permit $35.00 $35.00 $0.00 $35.00
$268.86 $268.86 $0.00 $268.86
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: RMB Printed By: JAS Print Date: 2/4/2003
lid;1 PROJECT APPLICATION WORK SHEET
ilk
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
SPOII Coni rl' 509-477-3675
SPECIFIC SITE INFORMATION
Street Address: l2ig7
lli4
Assessor's Tax Parcel Number(s): 3 `y..._6/0/
Legal Description: n
Lo r 2j" /6l/G AF jA-w i 4..t h"
ProjectiDescription: 64®2 4y ,_
$1 Building 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
,3 t.5 Left Right:
OWNER/APPLICANT INFORMATION
El Indlea/e who should be con/tided,rgurdin,/hi,gr'i't/
�CTyner. 57.:De &JTf2/4....;41 Phone: (j 12. -3 Is-7 CI Applicant:
Phone
P/4/2,16 2)A-vIS Fax: 6,x2 -3.1'1q ce>7.- G
Fax:
Mailing Address: Mailing Address:
A Zey 3y6,X
Cin',State,%i Cite,State,Zip
❑Cot`itr,actor Phone ❑ Architect I.rpncer Phone
5e2.-/"."
lax
Mailing address Mailing address
Cin,State Zip Cite,State Zip
\\A State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stones Main floor sq.ft.
rL nfirushed basement sq.ft.
/ ,.._
Dimensions 33 Total habitable space 2a�t floors ft.
3 � 9 Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.f
t.
Cost of project I Teat source(electric,gas,etc.)
Manufactured Home Sign
Width: length: What is the square footage of the sign I low high is the sign?
face?
Year: Make: #of signs Arca of existing signs
Relocation Fire Safety
hire Sprinkler Tent
Previous address
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name
Phone Plans Examiner Phone
Address
Inspectors:
Inspector Phone
0 Concrete 0 Welding O Bolting 0 Reinforcement '1c1iTress
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes XNo What is the current property size? _`
If yes,identify on site plan (square feet or acres) G.WO C")
Is any part of the property within 250 feet of a shore ne? What is the current use of this property?
If yes,identify on site plan 0 Yes No //�A
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes No
0 Don't know 0 Yes 7 No
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?.
If yes,identify on site planI f yes,identifi,on the site plan 0 Yes in No
0 Maybe 0 Don't know 0 Yes No
Are there any wetlands,streams or ponds within 20 feet of the property? Is there evidence of fill or excavation on the property?
If yes,identify on site plan 0 Yes No 0 Yes Pg No
Are there slopes greater than 30%on the property?(30 f se in 100 ft) Are critical or hazardous materials used or stored on si e?
( (de) 0 Yes No 0 Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No
17 Yes 0 N
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
DYes Cl No
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
DYes ONo
Date Received: Staff Representative
METHOD OF PAYMENT
ICV)i--( SUB101 Al
VISA t.Z ,, .
❑ CASII ❑ ClINCK 0 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D VI I:: I XPIRI?S: TOTAL FEE
B:\NKCAR1)NUblBI:R: MINIMUM PERMIT FEE IS$35.00 PLEASE
MAKE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
WTI TORI''/.I?ll SIGN;VPURI?:
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FRONT. ...S-5' FLANKING
REVIE' •;,':-.) BY
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This sits plon is being subm111%,A for fbn Trese of
obfaioln o 1 sl1r11n -per T-f ,_ ,..J is a.:,.. end correct
representallon of the pronesai All kno•.,vn property
lines/dimensioos, curb lines. sitactures and easements
.si Vt.
have bccn ...tontifieri A •o 1—'sated or..:woflands,
bodies of visitor, str: .1 or other cri,Jcal .. -
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Signed:___
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