2005, 02-22 Permit App 05000544 NW Ex Wall, Re-RoofProject Number: 05000544 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FIRE DAMAGE REPAIR - NW EXTERIOR WALL
AND RE -ROOF
Setbacks: Front
Site Information:
Left: Right: Rear:
Date: 02/22/2005 Page 1 of 2
Contact: COLUMBO, DAVID
Address: 18921 E VALLEYWAY AVE
C - S - Z: SPOKANE VALLEY, WA 99016
Phone: (509) 891-5809
Group Name:
Project Name:
Plat Key: 001092 Name: GUTHRIES VALLEY VIEW 05TH ADD
District: East
Parcel Number: 55173.1221 Block:
SiteAddress: 18921 E VALLEYWAY AVE
Location:: CSV
Zoning: UR-3.5
Water District:
Area: .00 Acres
Urban Residential 3.5
Width: 69
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Lot:
Owner: Name: COLUMBO, DAVID
Address: 18921 E VALLEYWAY AVE
SPOKANE VALLEY, WA 99016
Hold: ❑
Depth: 133 Right Of Way (ft): 60
Review
Plan Review
Permits:
Contractor: OWNER
Description Gar Type Notes
RESIDENCE R-3 VB FIRE
DAMAGE
REPAIR
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
Building Permit
Totals:
Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Su Ft Valuation Su Ft Valuation
0 $12,000.00 0 $12,000.00
0 $12,000.00
Units Unit Desc
1 SELECT
1 SELECT
Permit Total Fees:
0 $12,000.00
Fee Amount
$209.25
$4.50
$213.75
Operator: DMD Printed By: MT
Print Date: 02/22/2005
Project Number: 05000544
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Permit Type
Building Permit
Inv: /
Fee Amount Invoice Amount
$213.75 $213.75
Date: 02/22/2005 Page 2 of 2
Amount Paid Amount Owing
$213.75 $0.00
$213.75 $213.75
$213.75
$0.00
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: MT
Print Date: 02/22/2005
❑ Relocation
Spokane
jVauey
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: i $9 Z 1 E. Vt4Lt-E i 4Ay R va,
Assessor's Tax Parcel Number(s): 55113., i-2Z1
Legal Description: GuTi4R IES . VLV V14 5Th L21 132
PERMIT DESCRIPTION: Mtn ORt12,E D AMA GE - M W wL4 P-E-2-0cr
n Building Permit 7 Change in Use ❑ Grading ❑ Manufactured Home
Tenant Improvement (i Fire Safety ❑ Other
[1
OWNER/APPLICANT INFORMATION
Owner: bq.YtD.c1'Slehlal e Cowm,3o fl Applicant: SivME
Phone: V11-5809 Fax: Phone: Fax:
Address: 13i/1 E. VA-L w, 1446 • Address:
62 144-cazs wit gaa-tb
City State Zip Code City State Zip Code
Contractor: S$4,46
Phone:
Address:
Fax:
City
State
WA State Contractor License #:
Zip Code
❑ Architect:
Phone:
Address:
Fax:
City
Contact:
State
• Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2` D FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG: .
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA: •
COST OF PROJECT:
ft a , t:C573
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM?
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:
Inspector:
Address:
Phone:
Fax:
City
Phone:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
BOLTING
Firm Name:
CONCRETE
REINFORCEMENT n WELDING
Phone:
Inspector(s):
Fax:
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 fullcompliance 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)
fl Cash ❑ Check l Mastercard (l VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: