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2001, 12-06 Permit App: 01010675 Finish Basement Project Number: 01010675 Inv: 1 Application Date: 12/6/2001 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: FINISH BASEMENT Contact: ROSE,TOM Address: 12217 E 38TH AVE C-S -Z: SPOKANE,WA 99206 Setbacks: Front Left: Right: Rear: Phone: (509) 922-2026 Group Name: Site Information: Project Name: Plat Key: 005026 Name: MIDILOME 6TH ADD District: F Parcel Number: 45331.4107 Block: Lot: SiteAddress: 12217 E 38TH AVE Owner:Name: ROSE, TOM SPOKANE,WA 99206 Address: 12217 E 38TH AVE Location::SPO SPOKANE,WA 99206 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 0 Sq Ft Width: 84 Depth: 130 Right Of Way(ft): 50 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Revrew Inform o Review Plan Review � 6/ Releasedy: ermits: _......_...._............... P Operator: DMD Printed By: DMD Print Date: 12/6/2001 Project Number: 01010675 Inv: 1 Application Date: 12/6/2001 Page 2 of 3 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: Remodel Group: R-3 Type: VN Nbr Of Dwellings: Occupant Load: Building Height: Stories: Bldg W x D: x Building Sq Ft: Sprinklers: ❑ Req Parking: Handicap Parking: Critical Materials: This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation BASEMENT R R-3 VN FINISH 0 $6,000.00 0 $6,000.00 BASEMENT Totals: 0 $6,000.00 0 $6,000.00 Item Description Units Unit Desc Fee Amount RESIDENTIAL VALUATION 1 Y OR BLANK $113.00 STATE SURCHARGE 1 Y OR BLANK $4.50 RESIDENTIAL SURCHARGE 1 Y OR BLANK $24.86 Permit Total Fees: $142.36 Mechanical Permit Contractor: OWNER Finn: OWNER Address: 0 Phone: (000)000-0000 000000,00 000000 Item Description Units Unit Desc Fee Amount VENTILATING FANS 1 NUMBER OF $10.00 MINIMUM PEE ADJUSTMENT 1 Select $25.00 Permit Total Fees: $35.00 Plumbing Permit Contractor: OWNER Firm: OWNER Address: 0 Phone: (000)000-0000 000000,00 000000 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 1 NUMBER OF $6.00 SINKS 1 NUMBER OF $6.00 SHOWERS 1 NUMBER OF $6.00 MINIMUM FEE ADJUSTMENT 1 Select $17.00 Permit Total Fees: $35.00 Operator: DMD Printed By: DMD Print Date: 12/6/2001 Project Number: 01010675 Inv: 1 Application Date: 12/6/2001 Page 3 of 3 THIS IS NOT.A PERMIT Penalties will be assessed for commencing work without a permit Notes: .. 208 DRAINAGE REQUIRED Payment Summary Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $142.35 $142.35 $0.00 $142.35 Mechanical Permit $35.00 $35.00 $0.00 $35.00 Plumbing Permit $35.00 $35.00 $0.00 $35.00 $212.35 $212.35 $0.00 $212.35 Disclaimer: Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and fmds 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 contrued 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: 12/6/2001 i PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVIS,ION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE __ = SPOKANE,WA 99260 509-477-3675 - r b�,7S SPOKc COUNTY L SPECIFIC SITE INFORMATION Street Address: ;;7.0.7/ 7 I 3 Assessor's Tax Parcel Number(s): Legal Description: Project Description: (?AS,€Aihr✓T Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit El Relocation El Sign ❑ Tenant(New/Change) ❑ Other Department Use Only Water District/Purveyor. Sewer District/Purveyor, Road width Setbacks Front: Rear. School District FireDistrict: Zoning Left Right: OWNER/APPLICANT INFORMATION Indicate who should be eonlacied rrrardint lbisprojec/ ❑ Owner: Phone: ��yf C�"' 972•�d ❑ Applicant: Phone: /r ;v (n 0 51E- lax: lax: Mailing Address: Mailing Address: i;47/7 fC- 32( r A r/fc. City,State,Zip City,State,Zip S POkwef.f.. pu/i. 9?2o ❑ Contractor Phoneb Phone ❑ Architect,'lin unser Fax Fax Mailing address Mailing address Cite,State Zip Cin-,State Zip WA State Contractor license# Contact name: PROJECT INFORMATION Building Information Building height to peak #of stones Main floor sq.ft. Unfinished basement sAiftieir 4.45.14,1N 10P -Ca FT A®/WA' Dimensions Total habitable space 2st floor sq.ft. Finished basement sq.ft. Occupancy group Construction type Garage sq.ft. Deck sq. ft. Cost of project I teat source(electric,gas.etc.) Manufactured Home Sign Width: Length: What is the square footage of the sign I low 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 Arc there structures on the property? 71 Yes O No What is the current property size? Ifyes,identU'on site plan (square feet or acres) Is any part of the property within 250 feet of a shoreline?�yWhat is the current use of this property? Ifyes,identif'on site plan O Yes 4 No #0.44- Is p 4-Is your property in a designated wildlife habitat arca? Will the site be served by a septic system?O Yes No Don't know O Yes No Is any part of the property within a 100 yr flood plain? .1re or will there be wells located on the property? If yer,identi/,on site plan Ifyes,identyY on the site plan O Yes el No O Maybe ,Don't know O Yes O No Arc there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property? If yes,ident/Y on site plan O Yes kri No 8 Yes O No Are there slopes greater than 30°b on the property?(30 ft rise in 100 ft) Arc critical or hazardous materials used or stored on site? ( °%) O Yes ,i No O Yes 8 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No OYes 0 N Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes O" No OYes 0 N Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource Area? O Yes 0 No Date Received: Staff Representative METHOD OF PAYMENT MEMIC®VE SLTBTOT.V ❑ (:ASII 0 CI II{CK ❑ 0 ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD D 1 :: ICNPIRI:S: TOTAL FEE BANkCARD NUNIB1(R: MINIMUM PERMIT FEE IS$35.cASPLEASE Vt4KE CHECKS P:1S.A73LE TO SPOKANE .W11I(»2I%I:D SI GN ATL'RN: COUNTY PERMIT CENTER R