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2005, 02-02 Permit App: 05000320 AdditionProject Number: 05000320 Inv: 1 r q Application ' Date: 02/02/2005 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: 384 SQ FT BEDROOM AND DINING ROOM ADDITION Setbacks: Front NA Left: 10 Right: 30+ Rear: 61 Site Information: Plat Key: 001593 Name: MCLAUGHLIN ADD Contact: STEVENS, ALBERT R Address: 15115 E 26TH AVE C - S - Z: SPOKANE VALLEY, WA 99037 Phone: (509) 927-8516 Group Name: Project Name: District: Sout Parcel Number: 45264.1813 Block: SiteAddress: 15115 E 26TH AVE Location:: CSV Zoning: UR -3.5 Urban Residential 3.5 Water District: Lot: Owner: Name: STEVENS, ALBERT R Address: 15115 E 26TH AVE SPOKANE VALLEY, WA 99037 Hold: ❑ Area: .00 Acres Width: 86 Depth: 130 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Plan Review Released By: Permits: «; Operator: DMD Printed By: DMD Print Date: 02/02/2005 Project Number: 05000320 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 02/02/2005 Page 2 of 3 Contractor: OWNER Group: R-3 Type: VB Total Area 384 Building Height 16 Stories 1 Building Permit Firm: OWNER Phone: (000) 000-0000 Building Characteristics This Application: Total Project: DescriptionGrp Type Notes Sq Ft Valuation Sq Ft Valuation RES ADD R-3 VB 384 $28,677.12 384 $28,677.12 Totals: 384 $28,677.12 384 $28,677.12 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $431.65 STATE SURCHARGE 1 SELECT $4.50 RESIDENTIAL PLAN REVIEW 1 SELECT $172.66 Permit Total Fees: Mechanical Permit $608.81 Contractor: OWNER Firm: OWNER Phone: (000) 000-0000 Item Description Units Unit Desc Fee Amount VENTILATING FANS 1 NUMBER OF $10.00 CLOTHES DRYER 1 NUMBER OF $10.00 Contractor: OWNER Permit Total Fees: Plumbing Permit Firm: OWNER Phone: (000) 000-0000 $20.00 Item Description Units Unit Desc Fee Amount CLOTHES WASHER 1 NUMBER OF $6.00 Permit Total Fees: $6.00 Operator: DMD Printed By: DMD Print Date: 02/02/2005 Project Number: 05000320 Notes: Inv: 1 • Application Date: 02/02/2005 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Permit Type Building Permit Mechanical Permit Plumbing Permit Fee Amount $608.81 $20.00 $ 6.00 Invoice Amount $608.81 $20.00 $6.00 Amount Paid $0.00 $0.00 $0.00 Amount Owing $608.81 $20.00 $6.00 $634.81 $634.81 $0.00 $634.81 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: DMD Printed By: DMD Print Date: 02/02/2005 Spokane �Ual ley BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION 05�0`D Street Address: Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: (yl Building Permit Relocation Change in Use Tenant Improvement Grading Fire Safety Manufactured Home Other OWNER/APPLICANT INFORMATION Owner: /i/lz/ t /, �� 12 P� r Phone: Address:�-�- ,,C'/� //e. Cjr{yate Zip Code Contractor: Phone: Fax: Address: City State WA State Contractor License #: Zip Code Applicant: Phone: Address: Fax: City Architect: Phone: State Zip Code Address: Fax: City Contact: State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: MAIN FLOOR TO SQ. FTG: FINISHED BA MENT SQ. FTG: DIMENSIONS: 2 FLOOR SQ. FTG: # OF STORIES: UNFIN BASEMENT SQ. FTG GARAGE SQ.FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: COST OF PROJECT: TOTAL HABITABLE SPACE: 30% SLOPES ON PROPEPTTY- IMPERVIOUS SURFACE AREA: SEWER OR ON-SITE SEPTIC SYSTEM? ��f MANUFACTURED HOME Width: Manufacturer. Length: Year: Pit Set: RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: Tent: Valuation: # of Heads: Fire Alarm: Paint Booth: Fireworks Display: Blasting: Date/Time: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Inspector: Address: Phone: Fax: City Phone: State Fax: Zip City State Zip SPECIAL INSPECTIONS II BOLTING Firm Name: I CONCRETE REINFORCEMENT Phone: Inspector(s): Fax: WELDING DISCLAIMER 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 ermit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Dwnership of resulting development rights granted by any issued permit inure to the property owner. Tint Name Signature klethod of Payment: (Faxed permit applications will only be accepted with major bankcard) ] Cash lankcard #: Check Mastercard ,uthorized Signature: fl VISA n Other Expires: VIN#: 3 op /47 - N CDN ,A 1N W4°-- 17/Ip 106 a • t (Nuns G'- Gyro • "AL S-3000 0 pSi . r ARAGE , ARP©RTS &- PORCH S- 300 -41 -PSI • by 18" x 24" °r. GYPSUM -BOAR N ERI_¢RBRA D LL GON TRUCTION HA L BE PAS ENEDO F R ER THA64-7 O . n bau CONCRETE TQ COMPLY 1'O1RC TABLE 404.1. /f2'/ — s77d,•c Vim.//cy 1"# g'I im V/ -NE CLE R OFENIN �, „,,,. � i GRAS �.:.. ,� •. • . IM 5.O SO- FEET • X FINi5HE0 EML 3GE Iry itEUSIf44 l FR ILLHEIG 0 INCHES FLOOR rg9y 4� '' ING SHAT . BE x0011 1 OUT • .r' }sir 1I mmilim A 13 .H A ALARM WILL ACTIVATE ALL AL R S. 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F . • Ct- ZONEActonEss3f -26 lvC ROAD WIDTH FRONT COMMENTS REVIEWED 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 Tines/dimensions, curb lines, structutaaand a cements have been identified. Also indiaMed ars wittands, bodies of water, steep slopes or oiler critical areas. Signed: Date- C211Lite4' ciD