2001, 01-23 Permit App: 01000431 Remodel Project Number: 01000431 Inv: 1 Application Date: 1/23/01 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH BATHROOM IN BASEMENT Contact: PHARNESS,AL
Address: 12619 E 15TH AVE
C-S-Z: SPOKANE,WA 99216
Setbacks:Front Left: Right: Rear: Phone: (509)922-5114
Group Name:
Project Name
Site Information: , .
Plat Key: 001345 Name: JORGENS ADD District: F
Parcel Number: 45223.1233 Block: Lot:
SiteAddress: 12619 E 15TH AVE Owner:Name: PHARNESS,AL
SPOKANE,WA 99216 Address: 12619 E 15TH AVE
Location::SPO SPOKANE,WA 99216
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information: w "TF_
Department Review
BUILDING Plan Review LReleased By:
Hold Reasons: -O
Permit Conditions:
Permits:
Project Number: 01000431 Inv: 1 Application Date: 1/23/01 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
Address: 0 Phone: (000)000-0000
000000,00 000000
Building Characteristics
Const Category: Remodel Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN REMODEL 0 $3,000.00 0 $3,000.00
Totals: 0 $3,000.00 0 $3,000.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $75.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $16.61
Permit Total Fees: $96.61
Mechanical Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000)000-0000
000000,00 000000
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
Address: 0 Phone: (000)000-0000
000000,00 000000
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 1 NUMBER OF $6.00
SINKS 1 NUMBER OF $6.00
SHOWERS 1 NUMBER OF $6.00
SEWAGE EJECTOR 1 NUMBER OF $6.00
MINIMUM FEE ADJUSTMENT 1 Select $11.00
Permit Total Fees: $35.00
,
Project Number: 01000431 Inv: 1 `Application Date: 1/23/01 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary: r
Operator: RMB Printed By: RMB Print Date: 1/23/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $96.61 $96.61 $0.00 $96.61
Mechanical Permit $35.00 $35.00 $0.00 $35.00
Plumbing Permit $35.00 $35.00 $0.00 $35.00
$166.61 $166.61 $0.00 $166.61
,
ilkAPROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
illii
509-477-3675
SPOKAkECOWIN
SPECIFIC SITE INFORMATION
Street Address: l.2 R t t5 77.-i Aivc-
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: ,8i7 #60/11
0' Building Permit O Change in Use O Grading O Manufactured Home Permit
•
0 Relocation 0 Sign 0 Tenant (New/Change) 0 Other
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OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
Phone: 0 Applicant: Phone: 722..c://V
0 Owner: / L��p/T euE
� Fx:�.L /7xf P1-14bili Fax:
Mailing Address: Mailing Address _
/2609 AC7 /Z6 /� 4=7 , 4c 771`
City,State,ZipCity,State,Zip ..,2/
0 Contractor A / Phone •-• 2 / '�J4 ❑Architect/Engineer
Phone
Fax Fax
Mailing address Mailing address
City,State Zip �za_�/�-i/ t�/_�6` Ahr174% City,State Zip
WA State Contractor license N Contact name:
PROJECT INFORMATION _
NT
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.� _ :';',., �.. : _ " _ ,:. ..,..: .> ,,alz .gym 1,-w_.-
Buildingheight to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project Heat source(electric,gas,etc.)
Ids
.r' `Y>', t„v,11 mom. yrs ``�.""`w`�,,��� :a-�-�� .�P'...y� �. .,,.,-�, s _
Width: Fc
Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
4
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Firm Name Phone
Plans Examiner Phone
Inspectors: Address
Inspector Phone
0 Concrete 0 Welding 0 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,identlh 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,identify on site plan O Yes 0 No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes O No
0 Don't know O Yes 0 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 plan If yes,identify on the site plan 0 Yes O No
O Maybe 0 Don't know 0 Yes 0 No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property?
0 Yes 0 No
Ifyes,identify on site plan O Yes O 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 0 No O Yes O No
DEPARTMENT USE ONLY
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Date Received: Staff Representative:
METHOD OF PAYMENT
................
UC VE SUBTOTAL
VISA
❑ CASH ❑ CHECK ❑ iliENIE ❑ _ D •
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: EXPIRES: 3 "'�W
BANK CA RI)NUMBER:
— — MI7t7Ll#tTAfPERMI�',FF_£3SS3�e�3�5� `
AUTHORIZED SIGNATURE: MAKE CHEQCSPAYABI;ETtJ ZA ,
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