2005, 04-05 Permit App: 05001076 Finish Basement Project Number: 05001076 Inv: 1 Application Date: 04/05/2005 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 REC RM,BATHRM,2- Contact: CARVAJAL,CHRISTIAN&AMBER
BEDRMS&UTILITY RM Address: 4612 E 13TH AVE
C-S-Z: SPOKANE VALLEY,WA 99212
Setbacks:Front Left: Right: Rear: Phone: (509)000-0000
Group Name:
Site Information Project Name:
Plat Key: Name: WOODLAND TERRACE ADD District: Sout
Parcel Number: 35233.1117 Block: Lot:
SiteAddress: 4612 E 13TH AVE Owner:Name: CARVAJAL,CHRISTIAN&AMBE
Address: 4612 E 13TH AVE
Location::CSV SPOKANE VALLEY,WA 99212
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 7,020 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Plan Review Released By: _Iry
Permits:
Operator: K_C Printed By: K_C Print Date: 04/05/2005
Project Number: 05001076 Inv: 1 Date: 04/05/2005 Page 2 of 2
� Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Building Characteristics
Total Area 840
This Application: Total Project:
Description Grp Type Notes So Ft Valuation So Ft Valuation
BASEMENT R R-3 VB 840 $4,200.00 840 $4,200.00
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
Lots on the north side of 14th in the 4800 and 4900 block have fill. Soils investigation/foundation
engineering done by Strata(see plat file)requires:(1)footings=min.24 inches wide(2)foundations no
closer than 12 ft from north edge of fill
Lots on the north side of 14th in the 4800 and 4900 block have fill. Soils investigation/foundation
engineering done by Strata(see plat file)requires: (1)footings=min.24 inches wide(2)foundations no
closer than 12 ft from north edge of fill
CONTROL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary: �,. r.. ...
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: K_C Printed By: K_C Print Date: 04/05/2005
r •
BUILDING PERMIT APPLICATION WORKSHEE1
Spo' City of Spokane Valley Community Development Departmen
� � Building Divisior
1107 E. Sprague Avenue Suite 10(
ev.11 7 '
Spokane Valley, WA 9920E
40000*V
a) Phone: (509) 688-0036; Fax: (509) 688-003;
•
REQUIRED SITE INFORMATION •
•
Street Address: 4 I Z F ) ??1
Assessor's Tax Parcel Number(s):
Legal:Description: '
PERMIT DESCRIPTION: SF,r,-, �,,-I- �i "iS &44., y (A t +\ r v't) Z NArczmS,
Glo1-•
,r Building Permit ❑ Change in Use ' ❑ Grading ❑ Manufactured Home
El Relocation ❑ Tenant Improvement El Fire Safety ❑ Other
•
• OWNER/APPLICANT INFORMATION
. ❑ Owner: ah r 1St E 4-14,11,6, CA v k jJ ❑ Applicant:
Phone: z4 -W7-0K7Fax: Phone: Fax:
Address: 4A, 5 t30- gv-c_ Address:
pzokr..,e w sj 7,2/Z
Z
City State Zip Code City State Zip Code
El Contractor: ❑ Architect:
Phone: Fax: Phone: . Fax:
Address: • Address:
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: : FLOOR SQ_ FTG: -UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: 2 TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC.
SYSTEM? Jt�
• -
MANUFACTURED HOME
Width: Length: . Year: Pit Set: •
Manufacturer:
•
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 El 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 ' • 0 Check .❑ Mastercard ❑ VISA
❑ Other
Bankcard #: Expires: VIN#:
•
Authorized Signature:
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