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2002, 06-12 Permit App: 02004712 Addition Project Number: 02004712 Inv: 1 Application Date: 6/12/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 30 X 30 ADDITION TO EXISTING STEEEL Contact: WAGONER,SHIRLEY DENNIS BUILDING Address: 15505 E 14TH AVE C - S -Z: VERADALE,WA 99037 Setbacks: Front 90+ Left: EX Right: 16 Rear: 90 Phone: (509)922-1039 Group Name: Site Information: Project Name: Plat Key: 002316 Name: ROTCHFORD ACRE TRACTS . District: F Parcel Number: 45243.0218 Block: Lot: SiteAddress: 15505 E 14TH AVE Owner: Name: WAGONER,SHIRLEY DENNIS VERADALE,WA 99037 Address: 15505 E 14TH AVE Location::VER VERADALE,WA 99037 Zoning: UR-7 Urban Residential-7 Water District: Hold: ❑ Area: 0 Sq Ft Width: 150 Depth: 300 Right Of Way(ft): 60 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Review Information: Review 1111116 Site Plan Review Released By: ► t A e // Plan ReviewReleased 1� 1, Septic System Review Released By: �� Uy Permits: Operator: RMB Printed By: RMB Print Date: 6/12/2002 Project Number: 0200-1712 Inv: I 'Application Date: 6/12/2002 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: Addition Group: U-1 Type: VN Nbr Of Dwellings: 1 Occupant Load: 0 Building Height: 12 Stories: 1 Bldg W x D: 30 x 30 Building Sq Ft: 900 Sprinklers: Req Parking: 0 Handicap Parking: 0 Critical Materials: This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation GARAGE U-1 VN 900 $10,800.00 900 $10,800.00 Totals: 900 $10,800.00 900 $10,800.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $175.50 INVESTIGATION FEE 1 Y OR BLANK $175.50 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $38.61 Permit Total Fees: $394.11 Notes STOP WORK ORDER ISSUED BY D. HOWARD FOR AN ADDITION TO A POLE BUILDING WITHOUT A PERMIT. INVESTIGATION FEES REQUIRED. D. TRUAX Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $394.11 $394.11 $0.00 $394.11 $394A1 $394.11 $0.00 $394.11 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 contrued 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: 6/12/2002 i ( PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE 1111 SPOKANE,\VA 99260 SPOKE CW (FY 509-477-3675 ` SPECIFIC SITE INFORMATION li Street Address: i5 / sS-0 S / Assessor's Tax Parcel Number(s): L7kca 4/3 , O Z 1 Legal Description: • Project Description: K%g/f-/7-/Q it) lc X (S T ret' ' £[,,) 6 Building Permit ❑ Change in Use 0 Grading 0 Manufactured Home Permit 0 Relocation 0 Sign 0 Tenant(New/Change) 0 Other Depailnient Use Only Water District/Purveyor. Sewer District/Purveyor - • •Roadwidth. „SctbacEs Front Rear. .. - . School District. Fire District: - Zoning Left Right OWNER/APPLICANT INFORMATION El lndr<o!e who should be:on/ocred rrizrndin,g!his payed firthencr: Phone: q -- ❑Applicant: Phone 05-0 NL1 a Pa SKJ✓u�z 1 Fay Mailing:WJre5 `r' 6-0/t/ i'v Mailing Address r inns ic( 5"'\?..Of Cin,Stare,Lip City,State,Zip ^ ' 1)6e. it-La. 0 Contractor Phone ❑Architect/Fngincer Phone ]ITi� Fax Fax Madintq address - Marling address City,Stare Zip Cir",State I p WA State Contractor license= Contact name: PROJECT INFORMATION Building Information Building height to peak #of stones Main floor sq.ft_ Unfinished basement sq.ft. I)irri nsit,ns Total habitable space 2"d floor sq.ft. Finished basement sq.ft. Occerp:uue group Construction ape Garage sq.ft. Deck sq.ft. (asst of projea I k-at source(cketnc.gas.etc.) irr7L/0. W a read Set d / licJO c d-07 awe �0r�eer t,A9 SS (:t - but Cs) ( t ( iteuC Id n1, Manufactured Home Sign Width: Length: What is the square footage of the sign How high is the sign? face? Year. Make: #of signsi 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 0 Bolting 0 Reinforcement • Address ADDITIONAL SITE INFORMATION Arc there structures on the property? 0 Yes 0 No What is the current property size? Ifyes,/dent on rile pla!/ (square uare feet or acres) Is any part of the property within 250 feet of a shoreline? What is the current use of this property? f yrs,rdelitOf o!!site plan 0 Yes 0 Na 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? Arc or will there be wells located on the property? Ifyes,identdy on site plan f yes identift on the site plan 0 Maybe 0 Don't know O Yes 0 No 0 Yes 0 No Arc there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property? fyes,identyy on site plan 0 Yes 0 No Are there slopes greater than 30%on the property?(30 ft rise in 100 It) 0 Yes 0 No P pAre critical or hazardous materials used or stored on site? 0 Yes 0 No O 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 O Yes O No Is the property inside the ASA?- 0 Yes 0 No Is public water available to the site? O Yes O No OYes 0 No Is the property inside the PSSA? O,Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? 0 Yes 0 No Date Rcca•i.c-J_ Staff Rcprescntati.c METHOD OF PAYMENT MINIM >' r�.ri' SUBl(YF i. • ❑ CASH ❑ c:lllic:l: ❑ ❑ . 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: I{\PII:I:S: TOTAL FEE BANKCIRD NUMBER: MINIMUM PERMIT PEELSS3S.ODPt.CA F \lnlIORIZ :D SIGN-\CURL_: \r+tr.clIccl�cP:�y.�lsltrosrol:int= COUNTY Pt7t\ti.1 CENTER / . •. ,. • ii, a5Si:,3 • t . ` , v• W • a".S n u... . • • . it . c • , .............„ ....er_____...5 1 ---s, z.J -.-t This site plan is being submitted for the purpose of *obtaining a building permit and is a true and correct. • representation of the proposal.All known property lines/di ' ns,curb lines,structures and easements h been ide tified.Also indica .d are wetlands, 't odies of wat r,steep slopes olther critical areas. • ..Signed: 6 • •---1-"V"-- W h , Date J •• ,. • i f'. ✓ • C YY _ + < ,,:40 . . . . • ...,,,g. ' . , fi N '= 9-9tw .s •-1. -5-1-2 c • rnn N • A / v. ADDRESS: • ZONE: 'r= � ROAD WIDTH: <Q( FRONT*1.•• (..... b1 .../3,r2-Ce-- . ......�