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2002, 09-23 Permit App: 02008263 Addition Projr ct Number: 02008263 Inv: I Application Date: 9/23/2002 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: BEDROOM &BATHROOM ADDITION TO Contact: BOLDING,JAMES RESIDENCE Address: 11316 E 12TH AVE C - S -Z: SPOKANE,WA 99206 Setbacks: Front EXI Left: 20 Right: 20 Rear: 20+ Phone: (509)979-3984 Group Name: Site Information: Project Name: Plat Key: 999999 Name: RANGE District: F Parcel Number: 45213.9097 Block: Lot: SiteAddress: 11316 E 12TH AVE Owner: Name: BOLDING,JAMES SPOKANE,WA 99206 Address: 11316 E 12TH AVE Location::SPO SPOKANE,WA 99206 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 25,420 Sq Ft Width: 82 Depth: 310 Right Of Way(ft): 40 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Review Site Plan Review _ Released By: , _f • Plan Review - Released —VW Operator: RMB Printed By: RMB Print Date: 9/23/2002 Project Number: 02008263 Inv: 1 Application Date: 9/23/2002 Page 2 of 3 • 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: II Req Parking: Handicap Parking: Critical Materials: El This Application: Total Project: Description Grp Type Notes Sq Ft Valuation So Ft Valuation RES ADD R-3 VN 320 $21,120.00 320 $21,120.00 Totals: 320 $21,120.00 320 $21,120.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $313.00 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $68.86 Permit Total Fees: $386.36 Mechanical Permit Contractor: OWNER Firm: OWNER Phone: Item Description Units Unit Desc Fee Amount VENTILATING FANS 1 NUMBER OF $10.00 MINIMUM FEE ADJUSTMENT 1 Select $25.00 Permit Total Fees: $35.00 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 TUBS 1 NUMBER OF $6.00 MINIMUM FEE ADJUSTMENT 1 Select $17.00 Permit Total Fees: $35.00 Operator: RMB Printed By: RMB Print Date: 9/23/2002 r � Project Number: 02008263 Inv: 1 Application Date: 9/23/2002 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Notes ..... Payment ummary• Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $386.36 $386.36 $0.00 $386.36 Mechanical Permit $35.00 $35.00 $0.00 $35.00 Plumbing Permit $35.00 $35.00 $0.00 $35.00 $456.36 $456.36 $0.00 $456.36 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: RMB Print Date: 9/23/2002 f lOct PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE ___= SPOKANE,WA 99260 509-477-3675 SPoKANECouNTY SPECIFIC SITE INFORMATION Street Address: ' t /_ E. 1 Zl. Assessor's Tax Parcel Number(s): 4 5z t 3 i 0 9 l Legal Description:. 3 l4 ai -as - 44 Project Description: er -"�` EY 5uilding 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 Left: Right OWNER/APPLICANT INFORMATION El Indicale who should be contaoled rcnardiw;ibis prole5Y ❑�1n(�wneerr. Phone: q 75, � ❑ Applicant: Phone: V Y7 ri 1e" S W —66%.: 1v4c3l.ac lax: Mailing Address: Mailing.Address: 113\ 6 c t 2. -R..r City,State,Zip City,State,Zip 5Pak a,l6-`, teJA `5?'?20 6 CI Contractor Phone b Phone ❑ Archi[ecdl:n nnccr Fax lax Mailing address Mailing address City,State Zip City,State Zip WA State Contractor license# Contact name: PROJECT INFORMATION Building Information Building height to peak #of storiesoto q A Main floor sq.ft. Unfinished basement sq.ft. Dimensions ( ( Total habitable space 2"'l floor sq.ft. Finished basement sq.ft. Occupancy group Construction type Garage sq.ft., ^ Deck sq.ft. Cost of projectI feat source(electric,gas,etc.) 2c� ,e>oma .` t !" / • �. 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 O Welding O Bolting O Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? r Yes 0 No What is the current property size? Ifyes,identz'on site plan (square feet or acres) C 2- Is any part of the property within 250 feet of a shoreline? What is the cwent use of this prope ? Ifyes,identify on site plan 0 Yes A No yam' .'l 0*► Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes A No 0 Don't know 0 Yes 115r No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? Ifyes,ident j,on site plan Ifyes,identi on the site plan 0 Yes KNo 0 Maybe 0 Don't know 0 Yes "Z..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,identz,on site plan 0 Yes ?Kt No 0 Yes *No Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site? ( %) 0 Yes PE No 0 Yes IK,No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No OYes ONo Is the property inside the ASA? O Yes 0 No Is public water available to the site? 0 Yes 0 No O Yes O No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? OYes ONo Date Received. Staff Representative: METHOD OF PAYMENT NEM Ziti;:'-11' Cilf� - SUBTOTAL. VISA 0 C.vSI1 0 CHECK 0 0 . 0 -- FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD D:ATI EXPIRES: TOTAL FEE BAN KC\Rl)NLIMBI':R: MINIMUM PERMIT FEE IS$35.00PLFASE MAKE C}IECKS PAYABLE TO SPOKANE ALIT]IORIXI'D SIGNATURF: COUNTY PERMIT CENTER • cAtin�c- q �RFSS• ,:, fie-i fr C �-I,= ' E --c. • . _ 024 C� , ,o ,�� 9F�,'��IF ONS►,'—. �a:� ��/yi • ' f Pir r liki .NIFP .N% • • ik >4..‘ :' ' Q i l 5 r f ID. tive � N 'kr 1 li , - ---TS • 4 /I ----f J .. ,T ( ( r ( ( ( < ( ( ( ( ( ( ( , This site p'3~ -.,1 _ :'c.+f-)r tr,e. obtainr:; -;--irpose of ,:i pa -3-rd is a fait and correct representation of the proposal All known property lines/dimensions, urb lines F ucturest and easements have been identifi- , i? a . rr t ds, bodies of ilater st:-. is • .r I o cr, i� ;areas. Signed: . _ • rs Date ,I — -----