2005, 04-08 Permit App: 05001124 AdditionS
Project Number: 05001124 Inv: I Application Date: 04/08/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Protect Information:
Permit Use: 16 X 18 WORKSHOP ADDITION TO GARAGE Contact: SAMPLES, GEORGE
Address: 13618 E 25TH AVE
C - S - Z: SPOKANE VALLEY, WA 99216
Setbacks: Front N/A Left: EX Right: 12 Rear: 50+ Phone: (509) 926-5477
Group Name:
Site Information: Project Name
Plat Key: 001705 Name: MOUNTAIN VIEW 04TH ADD District: Sout
Parcel Number: 45274.0205 Block:
SiteAddress: 13618 E 25TH AVE
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: .00 Acres Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot:
Owner: Name: SAMPLES, GEORGE
Address: 13618 E 25TH AVE
SPOKANE VALLEY, WA 99216
Hold: ❑
Depth: 0 Right Of Way (ft): 60
Review Information:�..�rE
Review
Site Plan Review
Plan Review
Permits:
Released By:
Released By:
Operator: K C Printed By: K C Print Date: 04/08/2005
a
Project Number: 05001124 Inv: 1Application Date: 04/08/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Group: U-1 Type: VB
Total Area 288
Building Height 14
Stories 1
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Permit Total Fees
Total Project:
Sa Ft Valuation
0 $8,000.00
0 $8,000.00
Fee Amount
$153.25
$38.31
$4.50
$196.06
Notes:
Payment Summary hMW" , eU . \M �eta ',e .a, '
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owins
Building Permit $196.06 $196.06 $0.00 $196.06
$196.06 $196.06 $0.00 $196.06
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: 04/08/2005
This Application:
Description Grp Tyne
Notes
So Ft Valuation
GARAGE U-1 VB
VALUATIO
0 $8,000.00
N GIVEN
BY OWNER
Totals:
0 $8,000.00
Item Description
Units
Unit Desc
RESIDENTIAL PERMIT FEE
1
SELECT
ACCESSORY PLAN REVIEW
1
SELECT
STATE SURCHARGE
1
SELECT
Permit Total Fees
Total Project:
Sa Ft Valuation
0 $8,000.00
0 $8,000.00
Fee Amount
$153.25
$38.31
$4.50
$196.06
Notes:
Payment Summary hMW" , eU . \M �eta ',e .a, '
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owins
Building Permit $196.06 $196.06 $0.00 $196.06
$196.06 $196.06 $0.00 $196.06
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: 04/08/2005
BUILDING PERMIT APPLICATION WORKSHEET
cr1 E Cty, �`l Valley Community Development Department
S 111 �/ Building Divi
�� g son
tf, 5 11707 E. Sprague Avenue, Suite 106
�� # Spokane Valley, WA 99206
one: (509) 688-0036; Fax: (509) 688-0037
D UHLDHM( __11
�j REQUIRED SITE INFORMATION ii
Street Address: JG ,E , `-�
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: lG x
5T
5 T T -L S-)-' E /�S-�`T �_6 BZ
, cic�`!7133
,,Building Permit ❑ Change in Use ❑ Grading
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety
❑ Manufactured Home
❑ Other
11 OWNERIAPPLICANT INFORMATION II
Owner: C� rr e_ t:--, Sa yV li s
Phone: '?J6- ! �'7 7Fax: /—Y/
`Address: /3 G/,? T___< 2.5 -_r�i 4u,,
4
city State Zip Code
❑ Contractor:
Phone: Fax:
Address:
city
State Zip Code
WA State Contractor License #:
® Applicant
Phone: _
Address:
City
❑ Architect:
Phone:
Address:
city
Contact:
PERMIT/BUILDING INFORMATION
Fax:
Q State Zip Code
Fax:
State Zip Code
HEIGHT TO PEAK:
DIMENSIONS: /(' X le
# OF STORIES:
MAIN FLOOR.TO SQ_ FTG: 8�
2 LI _..FLOOR SQ_ FTG: //4 _
UNFIN BASEMENT SQ_ FTG 4/14
FINISHED BASEMENT VZJTG:
((��ll
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG: I/4
OCCUPANCY GROUP:
CONSTRUCTION TYPE: Uo,) � �
HEAT SOURCE:
# OF BEDROOMS: MM .
TOTAL HABITABLE SPACE: N/�
IMPERVIOUS SURFACE AREA:
COST OF PROJECTOy oj�O
30% SLOPES ON PROPERTY:
SEWER SITE aePMN/
Width: Length:
Manufacturer:
Previous Address:
Proposed Use: _
Fire Sprinkler:
Tent:
Valuation:
MANUFACTURED HOME N
Year:
RELOCATION N
FIRE SAFETY K L4
# of Heads: Fire Alarm:
Fireworks Display: Blasting:
Above/Underground Storage Tank Size:
Pit Set:
Paint Booth:
Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
❑ BOLTING
Firm Name:
I nspector(s):
DISCLAIMER
Phone:
Phone:
SPECIAL INSPECTIONS
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Fax:
Fax:
State
Fax:
Zip
Zip
❑ WELDING
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 per t i ure to the pr erty o er.
Print Name 0% Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard VISA
Bankcard #:
Authorized Signature:
Expires: on 07
VIN#:
❑ Other
ADDRESS
ZONE Z t 1<'
ROAD WIDTH
FRONT ' I FLANKING
COMMENTS
REVIEWED BY iA
<dS> h A ve-
t N
ay D 6 f?74
Evev-qreen
V
This sft p1m Is beinc submitted r oie Purpose of
obta" a building p)rmit ami is j : �e and correct
represerAMMon of the proposal Ai- knuwn property
IiMIrs,curb finw; inde-011 I
hwo IMsl1 idMtitied. Also i-. .
wegends,
boOn 4409 ste C slopes jr other woes.
some*