2002, 06-19 Permit App 02004970 Pole BldgProject Number: 02004970 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information: . . . .............. . . . . .........
Permit Use: 24 X 30 POLE BUILDING Contact: LONNY POWERS
Address: 11223 E 4TH AVE
C - S - Z: SPOKANE, WA 99206
Setbacks: Front 50+ Left: 40 Right: 20+ Rear: 5 Phone: (509) 926-6353
Group Name:
Project Name:
Site Information:
Plat Key: CONV Name: CONVERTED CNTY DATA District: F
Date: 6/19/2002 Page 1 of 2
Parcel Number: 45212.0714 Block: Lot:
SiteAddress: 11223 E 4TH AVE Owner: Name: MONTENEGRO
SPOKANE, WA 99206 Address: 448 ANNIE PLACE
Location:: SPO CHENEY, WA 99004
Zoning: UR-3.5
Water District:
Urban Residential 3.5
Hold: El
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review
Site Plan Review
_ .
L
Plan Review
Operator: RMB Printed By: RMB Print Date: 6/19/2002
Project Number: 02004970 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Date: 6/19/2002 Page 2 of 2
Contractor: ALPINE CUSTOM BUILDINGS Firm: ALPINE CUSTOM BUILDINGS
Address: 502 S PINES RD Phone: (800) 922-2036
SPOKANE, WA 99206
Building Characteristics
Const Category: New Group: U-1 Type: VN
Nbr Of Dwellings: 1 Occupant Load: 0 Building Height: 14 Stories: 1
Bldg W x D: 24 x 30 Building Sq Ft: 720 Sprinklers: ❑
Req Parking: 0 Handicap Parking: 0 Critical Materials: ❑
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VN 720 $8,640.00 720 $8,640.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes:
Permit Type
Building Permit
Totals: 720 $8,640.00 720 $8,640.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Fee Amount
$150.50
$4.50
$33.11
$188.11
Fee Amount Invoice Amount Amount Paid Amount Owing
$188.11 $188.11
$188.11 $188.11
$0.00 $188.11
$0.00 $188.11
.....................
.....................
.....................
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Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fmds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: RMB Printed By: RMB
Print Date: 6/19/2002
11
SPOKE COUNTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: NuC
Assessor's Tax Parcel Number(s): (IS a / a 0 7/ y
Legal Description:
• ,gvviiA-.S 93/zo$oS08 QK /D Q(r 13
4 r./ od 131-k i 25- o/aPPofTur/ y
Project Description:
Pale .gam//at
❑ Building Permit
O Change in Use
O Grading
O Manufactured Homc Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
- -
Road width
-
Setbacks
Front - Rear.
I .eft Right:
School District
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
0 lndica/e who should be eontacted rej ardinp ibis ¢rnieaY
0 Owner: Phone cry_ $ _S 88 Y
/ f(' /'76 / v%Cfe g a) Fax:
LK Arplicant: Phone: J (.'? 1: = �rCa
1.,0 "44.19 P Fax:
Mailing Address:
951$ iv)e P/a ce-
Mailing Address:
.t/22 3 F1' 5,
City, State, Zip
cLr>,ney 1-,J.4.
P O5
City, State, Zip
SOa%fanc c— 94 Zo6
0 Contractor PhoneSO7' % 7. 7111s
A,49111e G_itTo►ti,. 61.)4 Fa.So9-4i27-/o/g
❑ Architect Mt Phone s'D1--eiy_T—b494
ba,`nek,/,_ /Jiff.i64eFax S.o4-5rY8-f682
Mailing address
Soo P/y1CS
Mailing address
2a9/3 E 6/ r Coc.3rT
City, State Zip
�o4}-,c
fit. '7q7 6
City, State Zi
SGbka,-,e 4.)0. iyz//
WA State Contractor license #
6 &P;tiC R <Sj/tf 9
Contact name:
et,n i'et._ i--)40 ,► k-�
PROTECT INFORMATION
Building Information
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
yy 5 a
Total habitable space
-��`
2ro floor sq. ft.
/2----,
Finished basement sq. ft.
��
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project J�
1 Teat source (electric, gas, etc.)
Manufactured . Home
Sign
Width:
Length:
What is the square footage of the sign
face?
I-Iow high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation
Fire Safety
Previous address
Fire Sprinkler
Tent
Fireworks display
Paint booth _ Fire Alarm
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Finn Name
Phone
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
.,Concrete
D Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property?'S'es O No
Ifyes, ident6, on site plan
What is the current property size?
(square feet or acres) /0 28(9.1
Is any part of the property within 250 feet of a shoreline?
Ilya, identij on site plan O Yes No
What is the current use of this property?
' QQ_ e,1-/'
Is your property in a designated wildlife habitat area?
O Don't know O Ycs erSfNo
Will the site be served by a septic system? O Yes No
Is any part of the property within a 100 yr flood plain?
Ifyes, identify on site plait
O Maybe O Don't know O Yes No
Are or will there be wells located on the property?
Ifyes, identify on the site plan O Yes
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, identi on site plan O Ycs 'No
Is there evidence of fill or excavation on the property?
O Yes o
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) O Yes Ai No
Are critical or hazardous materials used or stored on site.
O Yes etr No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
OYes ONo
Is public sewer available to the site? O Yes O No
Is the property inside the ASA? O Yes 0 No
D Yes O No
Is public water available to the site? O 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?
OYes .ONo
Date Received:
Staff Representative:
METHOD OF PAYMENT
❑ CASH ❑ CIIECK
111111111111 NW -
VISA
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35 00PLEASE
MAKE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
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