2002, 11-06 Permit App 02009935 GarageProject Number: 02009935 Inv: I
Application Date: 11/6/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
. . .
...................................................................
................................................................
Permit Use: 30 X 33 ATTACHED GARAGE
Setbacks: Front 73 Left: 16 Right: EX Rear: 50+
Site Information:
..........................................
Plat Key: 002756 Name: VERA
Contact: BLEW, TIMOTHY
Address: E. 16715 BROADWAY AVE
C - S - Z: VERADALE, WA 99037
Phone: (509) 892-1710
Group Name:
Project Name:
.............................................................................................................
District: F
Parcel Number: 45131.0226 Block: Lot:
SiteAddress: 16715 E BROADWAY AVE Owner: Name: BLEW, TIMOTHY
SPOKANE, WA 99206 Address: E. 16715 BROADWAY AVE
Location:: VER VERADALE, WA 99037
Zoning: UR 3.5 Urban Residential 3.5
Water District:
Hold: ❑
Area: 0 Sq Ft Width: 110 Depth: 310 Right Of Way (ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 1
...............................................
Review
Site Plan Review
S�Ce�c
Plan Review
....................
Released By:
Septic System Review ?AZ
Permits:
Operator: RMB Printed By: RMB
Print Date: 11/6/2002
Project Number: 02009935 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Const Category: Addition
Nbr Of Dwellings:
Bldg W x D: x
Req Parking:
Building Permit
Date: 11/6/2002
Page 2 of 2
Firm: OWNER
Phone:
Building Characteristics
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Description Grp Type Notes
GARAGE U-1 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Type:
Building Height:
Sprinklers:
Critical Materials: El
This Application:
Sq Ft Valuation
990 $11,880.00
Totals: 990 $11,880.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Stories:
Total Project:
Sq Ft Valuation
990 $11,880.00
990 $11,880.00
Fee Amount
$188.00
$4.50
$41.36
$233.86
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $233.86 $233.86 $0.00 $233.86
$233.86 $233.86 $0.00 $233.86
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: RMB Printed By: RMB
Print Date: 11/6/2002
1
SPOKANE COUNTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
Alt. /67i 3 16,6ru c .X Xt
Assessor's Tax Parcel Number(s):
r
UZC% 7o3 /
Legal Description:
Project Description: jq�4 J �' Ci1Ci PCn eJ +O n n u s e
Ig Building Permit
❑ Change in Use
❑ Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear:
].eft: ltighr
School District
Fire District
Zoning
OWNER/APPLICANT INFORMATION
Indica!e oho slior+ld be eoalatied ireanlioo Ibis brofed
0 Owner..
Phone(5Oq) 8ga-17) 0
eV e t) Fax:
❑ Applicant:
Phone:
Fax:
r
�VY1 Ci fly >i / •
Mailing Address:``
,E. /6 >i3—
e read wo.y
Mailing Address:
City, State, Zip
t)t c 4(€
(
W-, 7 9 0 3 )
City, State, Zip
0 Contractor
Phone
Fax
0 Architect/Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
PROTECT INFORMATION
Building Information
Building height to peak r
aD
# of stories
one
Main floor sq. ft.
Unfinished basement s . ft.
Dimensions •
30' x 23
Total habitable space
2ne1 floor sq. ft.
Finished basement sc3. ft.
Occupancy group
Constru tion type
a y6) ;Noor& collYk.ie{tav
Garage sq. ft.
990 51 "Pt-
Deck sq. ft.
'
Cost of project od
,( Soo '
Heat source (electric, gas, etc.)
!Uo!u E
Manufactured Home
Sign
Width:
Length:
What is the squa_: footage of the sign
face?
1-low high is the sign?
Year: /
Make:
# of signs /
Area of existing signs
Relocation
Fire Safety' -
Previous address
J
,'
Paint booth
Fire Sprinkler
Tent
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? Pr Yes 0 No
Ifyes identify on site plan
What is the current property size? / /
(square feet or acres) a i/ O X go
Is any part of the property within 250 feet of a shorelines?
Ifyes, identifyonsite plan 0 Yes L7'No
What is the,current use of th,is, prop rty? A
NJVe(501U i'cl ritly KesAeVCe_
Is your property in a designated wildlife habitat area? �
O Don't know 0 Yes L�J No
Will the site be served by a septic system? 0 Yes ®'CIO
Is any part of the property within a 100 yr flood plain?
Ifyes, identjft on site plan
0 Maybe 0 Don't know O Yes ail No
Are or will there be wells located on the property?
Ifj�es ident' on the site plan 0 Yes [rT/No
Are there any wetlands, streams or ponds within 200 f of the property?
Ifyes identify on site plan O Yes o
Is there evidence of fill or excavation on the property? ��
O Yes Pd No
Are there slopes greater than 30% on the property? (30 ftp.aelii 100 ft)
( / %) 0 Yes No
Are critical or hazardous materials used or stored on site?
0 Yes C3 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
OYes ONo
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No
Is the property located within 1000 feet of a Natural Resource Area?
O Yes O No
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASIJ ❑ CHECK ❑ mum❑
MOWER
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL
TOTAL FEE
MINIMUM Pl'RMITFEE IS d35.00PLEASE
.. MAKE CHECKS PAYABLE TO SPOKANE
. COUNTY PERMIT CENTER
1
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