2005, 06-27 Permit App 05002192 Garage, DeckProject Number: 05002192 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: ADD 576 SQ FT GARAGE& 1000 SQ FT COVERED
DECK TO EXISTING GARAGE
Setbacks: Front EXI Left: 7 Right: N/ Rear: 25
Site Information:
Plat Key: 000000 Name: TIMBERLANE 01ST ADD
Date: 06/27/2005 Page 1 of 2
Contact: MASON, RICHARD
Address: 15918 E CAMERON CT
C - S - Z: SPOKANE VALLEY, WA 99037
Phone: (509) 953-3923
Group Name:
Project Name:
District: Sout
Parcel Number: 45253.0527 Block:
SiteAddress: 15918 E CAMERON CT
Location:: CSV
Zoning: UR-3.5
Water District:
Urban Residential 3.5
Lot:
Owner: Name: MASON, RICHARD
Address: 15918 E CAMERON CT
SPOKANE VALLEY, WA 99037
Hold: ❑
Area: i,800.00 Acres Width: 140 Depth: 170 Right Of Way (ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Released By: '(,1 'R i ` L i b
Plan Review
Permits:
Released By:
6Lvvvip tly(
Kc
Operator: K_C Printed By: K_C Print Date: 06/27/2005
Project Number: 05002192 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Date: 06/27/2005 Page 2 of 2
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VB GARAGE& 0 $60,000.00 0 $60,000.00
COV DECK
ADDN
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
Notes:
Payment Summary:
Permit Type
Building Permit
Totals: 0 $60,000.00 0 $60,000.00
Units Unit Desc
1 SELECT
1 SELECT
Permit Total Fees:
Fee Amount Invoice Amount
$718.25 $718.25
Fee Amount
$713.75
$4.50
Amount Paid
$0.00
$718.25
Amount Owing
$718.25
$718.25 $718.25
$0.00 $718.25
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: 06/27/2005
Spokane
jValley
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
Street Address: /5 %/e e.
Cimek-ovi C�
Assessor's Tax Parcel Number(s): 5SZ5 o52 %
Legal Description:
PERMIT DESCRIPTION: Addiko 74 (4ke
❑ Building Permit ❑ Change in Use ❑ Grading
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety
ide/a0 1.4,kita-i4x/:5-
❑ Manufactured Home
RI Other
OWNER/APPLICANT INFORMATION
❑ Owner. rG ) ki
Phone: y51.3-3 z3 Fax: V-7-6757
Address: iivi
City State Zp Code
❑ Contractor:
Phone:
Address:
Fax:
City
State
0 Applicant:
Phone:
Address:
See
Fax:
City
❑ Architect:
Ph
Ad
Zp Code City
WA State Contractor License #: Contact:
Spokane Valley Bus. Liscense #: Contact:
State
WILMN
Zip Code
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"u FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARA���. FTG: A
D �D� V. PAT SQ. FTG:
•
OCCUPANCY GROUP:
CONST UCTIO TYPE:
Ale-
HEAT SOU C :
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
CO T OF PROJECT:
P- cioL)
30% SLOPES ON PROPERTY:
SEWER OR -SITE SEPTIC
SYSTEM? it
MANUFACTURED HOME
Width:
Manufacturer:
Length:
Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner
Address:
Phone:
Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
II
BOLTING ❑ CONCRETE
Firm Name:
n 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
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 permit inure to the property owner.
Print Name
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
LJ Cash n Check ❑ Mastercard
Bankcard #:
Authorized Signature:
❑ VISA
n Other
Expires: VIN#:
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