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2001, 11-15 Permit App: 01010114 Addition t Project Number: 01010114 Inv: 1 Application Date: 11/15/2001 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: RESIDENCE ADDN-FAMILY RM,BATHRM, Contact: CLIFF SCHMITZ CONSTRUCTION MASTER BEDRM & GARAGE Address: 16520 E. SECRETARIAT C-S-Z: VERADALE,WA 99037 Setbacks:Front EXI Left: 12+ Right: 26+ Rear: 80 Phone: (509)922-4297 Group Name: Site Information: Project Name: Plat Key: 002392 Name: SKYVIEW ACRES ADD District: F Parcel Number: 45284.1621 Block: Lot: SiteAddress: 12003 E 30TH AVE Owner:Name: STORZ,ERIC SPOKANE,WA 99206 Address: 12003 E 30TH AVE Location::SPO SPOKANE,WA 99206 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 1 Site Plan Review Released By: g ,}ti'lh .\„C Plan Review Released By: \ -.. - ,s_.., -4 1 Permits: ❑1'L�,k:.C;,t.k. . ..::.: : .... ......................... Operator: MKC Printed By: MKC Print Date: 11/15/2001 Project Number: 01010114 Inv: 1 Application Date: 11/15/2001 Page 2 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Building Characteristics Const Category: Addition Group: R-3 Type: VN Nbr Of Dwellings: Occupant Load: Building Height: 15 Stories: 1 Bldg W x D: 60 x 24 Building Sq Ft: 1440 Sprinklers: El Req Parking: Handicap Parking: Critical Materials: This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation GARAGE U-1 VN 864 $10,368.00 864 $10,368.00 RES ADD R-3 VN 576 $35,712.00 576 $35,712.00 Totals: 1,440 $46,080.00 1,440 $46,080.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $550.00 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $121.00 Permit Total Fees: $675.50 Mechanical Permit Contractor: BLUE FLAME HEATING&A/C Firm: BLUE FLAME HEATING&A/C Address: 6011 E 9TH Phone: (509)536-0186 SPOKANE,WA 99212 Item Description Units Unit Desc Fee Amount DUCT SYSTEMS 2 NUMBER OF $20.00 VENTILATING FANS 1 NUMBER OF $10.00 MINIMUM FEE ADJUSTMENT 1 Select $5.00 Permit Total Fees: $35.00 Plumbing Permit Contractor: S T PLUMBING CO INC Firm: S T PLUMBING CO INC Address: P.O. BOX 1817 Phone: (509)244-5575 AIRWAY HEIGHTS,WA 99011 Item Description Units Unit Desc Fee Amount TOILETS/BIDETS 1 NUMBER OF $6.00 SINKS 2 NUMBER OF $12.00 SHOWERS 1 NUMBER OF $6.00 TUBS 1 NUMBER OF $6.00 MINIMUM FEE ADJUSTMENT 1 Select $5.00 Permit Total Fees: $35.00 Operator: MKC Printed By: MKC Print Date: 11/15/2001 Project Number: 01010114 Inv: 1 Application Date: 11/15/2001 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $675.50 $675.50 $0.00 $675.50 Mechanical Permit $35.00 $35.00 $0.00 $35.00 Plumbing Permit $35.00 $35.00 $0.00 $35.00 $745.50 $745.50 $0.00 $745.50 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. Subsequ• t iss ance of a permit shall not be contrued to be a permit for,or an approval of,any violation of any of the provisions of the co de o i any i th• state I local laws or ordinances. fff/ —� Signature: I Operator: MKC Printed By: MKC Print Date: 11/15/2001 0 . /O/ IL/ 1;1 PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE A SPOKANE,WA 99260 509-477-3675 SPOK N1 COUNTY SPECIFIC SITE INFORMATION Street Address: Assessor's Tax Parcel Numbcr(s): Legal Description: n � Project Description: I,l-('� S�f.7{J.�►'1 `�� Pe- ►'1"> fr �b..)) ,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 Dist' vac CAV Fire District: Zoning /N I3• 5 Left Right OWNER/APPLICANT INFORMATION 1 Indicate who should be contacted rekarding this profta ❑ Owner: Phone: ❑ Applicant: Phone: Fax: Fac Mailing Address: Mailing Address: City,State,Zip City,State,Zip K. Phone `r'yy-'77..�3 ❑ Architect/Iinginecr Phone (,int;act C, 1~f ' S CLA/6 .e:)', 89/-'/y')) Fax Mailing address Mailing address r / '; 0 6 . S F 6't t:el 4r <T City,State Zip City,State Zip Ue )”,...0-- QIP 99e)31'.2 WA State Contractor license# Contact name: d L`1 PsC /dy F PROJECT INFORMATION Building Information Building height to peak #of stones Main floor sq.ft. Unfinished basement sq.ft. /5- - / Iv --630' Dimensions Total habitable space 2°�l floor sq.ft. Finished basement sq.ft. &O Z q - /W(? .rte ' Occupancy group Construction type Garage sq.ft. Deck sq.ft. Cost of project I!cat source(electric,gas,etc.) 6 " J Z 3b a � Manufactured Home ' Sign Width: Length: i What is the square footage of the sign I Iow 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 O Concrete O Welding O Bolting O Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? O Yes O No What is the current property size? Ifyes,identib 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? Ifyes,identib on site plan O Yes O No Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes O No 0 Don't know O Yes O No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? Ifyes,identib on site plan Ifyes,identify on the site plan 0 Yes 0 No 0 Maybe 0 Don't know 0 Yes 0 No Arc there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property? Ifyes,identzf on site plan O Yes 0 No 0 Yes 0 No Arc there slopes greater than 30°%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site? ( /%) O Yes 0 No 0 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 0 Yes 0 No Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No OYes 0N Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? 0 Yes 0 No Date Received: Staff Representative: METHOD OF PAYMENT �C4Vf r SUBTOTAL VISA ❑ c.vsii ❑ (A WCK ❑ ,,.,,: ❑ ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD EXPIRES: TOTAL FEE B:ANKC.ARD NLIMBER: MINIMUM PERMIT FEE 15S35.0iPF.EASE AI KE CHECKS e v ABLE TO SPOKANE \U11lOR]'/.1 LD Sl(;N.ATURI' COUNtYPERMIT C1 NlE_R L ,� 09 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 (mown property lines/dimensions, curb in res and easements have been id nd are wetlands, bodies of t , s oso • tical areas. R A rj