2001, 09-25 Permit App: 01008358 Addition Project Number: 01008358 Inv: 1 Application Date: 9/25/01 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RES ADD-FAMILY ROOM Contact: GOSNEY,DONALD&RANEE
Address: 14408 E 23RD AVE
C-S-Z: VERADALE,WA 99037
Setbacks: Front Left: 18 Right: Rear: 51 Phone: (509)928-4129
Group Name:
Project Name:
Site Information
Plat Key: 000668 Name: EARLY DAWN 1ST ADD District: F
Parcel Number: 45262.2004 Block: Lot:
SiteAddress: 14408 E 23RD AVE Owner:Name: GOSNEY,DONALD&RANEE
VERADALE,WA 99037 Address: 14408 E 23RD AVE
Location::VER VERADALE,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 70 Depth: 131 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: :.. �n � , .:: =: „ 44'0404, =In
Department Review
BUILDING Site Plan Review Released,By:
Hold Reasons:
Permit Conditions:
Originally Released: 9/25/01 By: jshatto
BUILDING Plan Review Released',By:
Hold Reasons:
Permit Conditions:
Originally Released: 9/25/01 By: jshatto
Permits: --- KA -
•
Project Number: 01008358 Inv: 1 ' Date: 9/25/01 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
Address: 0 Phone: (000)000-0000
000000,00 000000
Building Characteristics
Const Category: Addition Group:R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories: 1
Bldg W x D: 20 x 16 Building Sq Ft: 320 Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: 111
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Su Ft Valuation
RES ADD R-3 VN 320 $19,840.00 320 $19,840.00
Totals: 320 $19,840.00 320 $19,840.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $288.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $63.36
Permit Total Fees: $355.86
Mechanical Permit
Contractor: OWNER Firm: OWNER
Address: 0 Phone: (000)000-0000
000000,00 000000
Item Description Units Unit Desc Fee Amount
GAS PIPING 1 #OF UNITS $1.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
MINIMUM FEE ADJUSTMENT I Select $24.00
Permit Total Fees: $35.00
Payment Summary• d,a� .ar,
Operator: JAS Printed By: JAS Print Date: 9/25/01
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $355.86 $355.86 $0.00 $355.86
Mechanical Permit $35.00 $35.00 $0.00 $35.00
$390.86 $390.86 $0.00 $390.86
Notes: . aMta MM . : .s aM ,... r 7 atm-,Aa
1
< < PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
_ = SPOKANE,WA 99260
509-477-3675
SPOKARE COUNTY
SPECIFIC SITE INFORMATION
Street Address: it 1 '--1 `, 1tO -/ 2 —0Q-
Assessor's Tax Parcel Number(s): (` �?� / y T
— �
Legal Description: O TOS
LO7 7 / ? Bloc % 9 / a ' w /,fst c?ddi7 /air
Project Description: AdG! Oh /iv/n9 rX' '7 / X� 0
Building 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 Indiaule mho tbould lx tanhhied m,urdin,g llrir pryjer!
❑ Owner. Phone: G' (//.9 ❑ Applicant: Phone
0 :1I1-PR C-JVJ/ICJ las: fax:
Mailing Address: Mailing Address:
E IL A
City,State,Zip City,State,Zip
W rcc d G k w a, c G 0 3 7
❑ Contractor Phone 71 :Architecti'I ngineer Phone
MIL.
SG
Mailing address Mailing address
City,State Zip Citi,State Zip
WA State contractor license# Contact name:
PROJECT INFORMATION
Building Information
Builing hei��ht to peak #of stories Main I oor g.ft. Unfinished basement sq.ft.
Lli
Dimensions I i)al habitable space 2"floor sq.ft. Finished basement se].ft.
\le`� '].(Q —J
Occupancy group Construction type Garage se].ft. Deck sq.ft.
Cost of project I feat source(electric,gas,etc.)
Manufactured Home Sign'
Width: Length: What is the square footage of the sign How 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
Arc there structures on the property? 0 Yes 0 No What is the current property size?
If yes,identilY 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,idem s on site plan 0 Yes 0 No
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? Are or will there be wells located on the property?
If yes,identift on site plan If yes,identifi,on the site plan 0 Yes 0 No
0 Maybe 0 Don't know 0 Yes 0 NO
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
Ifj:es,identif,on site plan 0 Yes 0 No 0 Yes 0 No
Are there slopes greater than 30°'o on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
O o) O Yes 0 No D 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
DYes 0N
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
DYes 0N
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
DYes El No
Date Received: staff Representative:
METHOD OF PAYMENT
11111111111 VISA =I E SUB"fO1':Al.
❑ ( \SII 0 CI11?CK 0 ❑ ❑ ..
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D:A7'I(: I(l plRl:S: TOTAL FEE
MINIMUM PERMIT FEE IS$35.010
B:ANK(;:ARl)NU 1BICR: IJ PLEASEa1AKECIIECKSPAYAI3I.ETo
SPOKANE COUNTY PERMIT CENTER
AUI'1IORI/El)SIGNATURE: _ *rl
Pella® WINDOW} SCAPING° Center
4A) SPOKANE,WA 1-800-873-7244
KENNEWICK,WA 1-800-873-7254
COEUR d'ALENE, ID 1-800-873-7264
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I nt 4 /1') C�:K Contractor: J-.,IOne'IQ Ot... %i'a c ti
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