2001, 05-21 Permit App: 01003807 Carport Project Number: 01003807 Inv: 1 Application Date: 5/21/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: CARPORT ADDITION(14 X 26 X 10) Contact: CAMPBELL,JEFF
Address: 12315 E 19TH AVE
C-S-Z: SPOKANE,WA 99216
Setbacks:Front 25 Left: Right: 5 Rear: Phone: (509)228-9052
Group Name:
Site Information:
Project Name:
Plat Key: 001222 Name: HILLCREST ACRES 1ST ADD District: F
Parcel Number: 45272.2518 Block: Lot:
SiteAddress: 12315 E 19TH AVE Owner:Name: CAMPBELL,JEFF
SPOKANE,WA 99216 Address: 12315 E 19TH AVE
Location::SPO SPOKANE,WA 99216
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 100 Depth: 120 Right Of Way(ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: r ;: :� .. gym,y, .
Department Review
BUILDING Site Plan Review \/}
Released By:
Hold Reasons:
Permit Conditions:
Originally Released: 5/21/01 By: jshatto
BUILDING Plan Review 4 Released'By:
Hold Reasons:
Permit Conditions:
Originally Released: 5/21/01 By: jshatto
Permits:
Project Number: 01003807 Inv: 1 Application Date: 5/21/01 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
Address: 0 Phone: (000)000-0000
000000,00 000000
Building Characteristics
Const Category: Addition Group:U-1 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories: 1
Bldg W x D: 14 x 26 Building Sq Ft: 364 Sprinklers: LI
Req Parking: Handicap Parking: Critical Materials: Li
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
CARPORT U-1 VN 364 $1,638.00 364 $1,638.00
Totals: 364 $1,638.00 364 $1,638.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $55.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $12.10
Permit Total Fees: $71.60
Payment Summary: f. F .
Operator: JAS Printed By: JAS Print Date: 5/21/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $71.60 $71.60 $0.00 $71.60
$71.60 $71.60 $0.00 $71.60
I , I PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
21111111116.—
SPOKANE,WA 99260
SPOxT�R.1r 509-477-3675
SPECIFIC SITE INFORMATION
Street Address: 12315 E. 19th Ave. Spokane, Wa. 99216
Assessor's Tax Parcel Number(s):
45272 . 2518
Legal Description:HILLCREST AC 1st L2 EXCW15FT; W28FT OF L3 B1
Project Description: 14x26 carport on east side
Building Permit 0 Change in Use 0 Grading 0 Manufactured Home Permit
0 Relocation O Sign 0 Tenant (New/Change) 0 Other
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OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
/Owner: Phone:2 2 8—9 0 5 2 O Applicant: Phone: 2 2 8—9 05 2
Jeff Campbell Fax: Jeff Campbell Fax:
Mailing Address: Mailing Address:
12315 E. 19 Ave.
City,State,Zip City,State,Zip
Spokane, Wa. 99216
0 Contractor Phone 0 Architect/Engineer Phone
Fax Fax
Mailing address Mailing address
City,State Zip City,State Zip
WA State Contractor license# Contact name:
PROJECT INFORMATION
hK4t W 3 3 s fr �"118411
® a3 a^ ''
9 a 3 r1;� t :. i�i-:;:. ...� s -
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
13 1
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
•
2'6x14x13x10 ' 5"
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
•
Cost of project Heat source(electric,gas,etc.)
3000 .00 none
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Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
a � , . —� �b.bm,..� ._ _ .� ., a.d., , ,6 e'er 5 i �1
Previous address Fire Sprinkler Tent
Paint booth_ Fire Alarm Fireworks display _
Proposed use Value
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Firm Name Phone Plans Examiner Phone
Inspectors Address
Inspector Phone
O Concrete 0 Welding 0 Bolting Cl Reinforcement Address
1 ADDITIONAL SITE INFORMATION
Are there structures on the property? Yes 0 No What is the current property si
11ze?
If yes,identify 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 Cl Yes 0 No single family dwelling
Is your property in a esignated wildlife habitat area? Will the site be served by a septic system?O Yes fp No
Don't know O Yes Cl 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 O Yes f4 No
O Maybe 'Don't know 0 Yes O No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes 0 No
If yes,identify on site plan 0 Yes 0 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?
( l%) O Yes r No 0 Yes pti No
DEPARTMENT USE ONLY
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Date Received: Staff Repre tative:
cam .. Di — d/
METHOD OF PAYMENT
SUBTOTAL
h25
0 CASH 0 CHECK 0 ❑ ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
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DATE: EXPIRES:
i
BANKCARD NUMBER: ,
-._ �sstwi :aa .
r . ` - � .AUTHORIZED SIGNATURE:
This site !an is being submitted for thepurpose of
obtaining a building permit and is a true and correct
representation of the proposal.All known property
lines/dimensions,curb lines,structures and easements --i
have been entified.Also indicated are wetlands,
bodies o w to,, =-p sic).-- or other critical areas. iij
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Signed: • i,
sir
Date:_ -5--2�' z
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