2003, 02-25 Permit App: 03001113 Pole Bldg Project Number: 03001113 Inv: 1 Application Date: 2/25/2003 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 24 X 26 POLE BUILDING Contact: JOHNONS,LYLE
Address: 9403 E 12TH AVE
C -S -Z: SPOKANE,WA 99206
Setbacks: Front 50+ Left: 20+ Right: 9 Rear: 9 Phone: (509)251-1225
Group Name:
Project Name:
Site Information:
Plat Key: 002378 Name: SIESTA MOBILE PARK ADD District: F
Parcel Number: 45203.0415 Block: Lot:
SiteAddress: 9403 E 12TH AVE Owner: Name: JOHNONS,LYLE
SPOKANE,WA 99206 Address: 9403 E 12TH AVE
Location::SPO SPOKANE,WA 99206
Zoning: UR-7 Urban Residential-7
Water District: Hold: ❑
Area: .00 Acres Width: 75 Depth: 100 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review �7 t
Site Plan Review Released B)r. �fr41-
Plan Review 1 � f
Re eased By: Q / 413
Septic System Review t ��' [Released By;
45/ — L -- _ . / _ / - /f /i 1.- AC�r��s,��2 L 2f Q
Permits:
Operator: RMB Printed By: RMB Print Date: 2/25/2003
• 1
Project Number: 03001113 Inv: 1ApphCation Date: 2/25/20113 Page 2 of 2
THIS IS NOT 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: LI
Req Parking: Handicap Parking: Critical Materials: ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VN 624 $7,488.00 624 $7,488.00
Totals: 624 $7,488.00 624 $7,488.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $138.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $30.36
Permit Total Fees: $172.86
Notes
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $172.86 $172.86 $0.00 $172.86
$172.86 $172.86 $0.00 $172.86
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 he 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: RMB Print Date: 2/25/2003
•
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PROJECT APPLICATION WORK SHEET
ii SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
6
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
509-477-3675
Srox Com-Y
SPECIFIC SITE INFORMATION
Street Address: 9 4,0 2 e / i de if v 41, ^01 All It OV.....
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: ,4/0 /3610/ .t/04 0&v.y , ..5.1/(1;'�'''� 4"'r
❑ Building Permit 0 Change in Use 0 Grading 0 Manufactured Home Permit
0 Relocation 0 Sign 0 Tenant(New/Change) 0 Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor Road width Setbacks
Front. Rear.
School District Fire District: Zoning
Left: Right
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted
rding this project
IJY .a-5_/• /2- Z
CTvner. y� Phone: ,.,2;,'f/ /Z L rApplicant: Phone:
.6f 64 �eafo'w;x'o 1 Fax: a. 9 / •• 6.?L' +� Fax:
Mailing Address: Mailing Address:
0„3 /•_ / 2 //../ 74#e)4.
City,$001W4
State,Zip 1 8 �p'� ,,r City,State,Zip
,rJ 0 1 b 4 /V/ i+'sly/e- 1, r Pe r t E �t''Jl'3 Fi"4 ell 1:.i met,''
0�Ctontractor �y Phone 0 Architect/Engineer Phone
V 14/7. ° Ai / old AZ—% Fax fG'- i/a/V1 F;.. Fax
Mailing address mow... Mailing address
/ /
City,State Zip City,State Zip
/ /
\VA State Contractor license# Contact name:
e / PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
/ 2 / 0� ,1'► 62. 4/ 6'' ,'C' p.a
Dimensions Total habitable space 2'd floor sq.ft. Finished cement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project I feat source(electric,gas,etc.)
3 ttlfra, $».p '
r
Manufactured Home " Sign '
Width: Length: What is the square footage of the sign I low 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
0 Concrete 0 Welding O Bolting 0 Reinforcement • Address
ADDITIONAL SITE INFORMATION
;Are there structures on the property? 0 Yes O No What is the current property size?
If yes,identifi,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?
If yes,idents 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?0 Yes 0 No
0 Don't know 0 Yes 0 No
Is any part of the property within a 100 yr flood plain? ;1re or will there be wells located on the property?
1 fyes,identj on site plan If j'es,identi fj'on 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?
If yes,identi_b'on site plan 0 Yes 0 No 0 Yes 0 No
Are there slopes greater than 30°o on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( ao) 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
MEM C of
SUBTOTAL,
0 CASA 0 CHECK ❑ ❑ 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATI I:: I:XPI RIS: TOTAL FEE
BANKCARD NPMIII':R: MINIMUM PERMIT FEE IS$35.A)PLEASE
MAKE CHECKS PAYABLE TO SPOKANE
ALM IORI%1'.I)SIGNAMRI?: COUNTY PERMITCE.NIER
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This Sita pion is being .ubmitted for the purpose of i
obtainin :.:'a..ing p:rtn!t C2nd is a true and correct
representation of the g roposal.All known property
lines/dimensions,curo lines.structures and easements
have been identified. •Iso indicate 're wetlands,
bodi: b0Pe5
s of waterr<sfeep ofriIare .
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Date'` 'P --Z $ — e23
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