2003, 12-16 Permit Application: BLD-03-3283 Double Wide Placement1
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
99707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688 -0036 Fax: (509)688 -0037
REQUIRED SITE INFORMATION
1
STREET ADDRESS: 1 Y7 /�✓ /f /t/
/ /
ASSESSOR'S TAX PARCEL NUMBER(S): �` s —/ g3 , 0 6 3 7
LEGAL DISCRIPTION: 47 // f /f t /�3 /7(47-.,--/1417,:,- / /�u
/12 !/43< r' $ T ✓ "� er /`'ece - ' . - 5p;P•40 (-re c/s091
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PERMIT DESCRIPTION:
0 BUILDING PERMIT 0 CHANGE IN USE 0 GRADING
RELOCATION
® SIGN EI TENANT
O'MANUFACTURED HOME
1 OTHER
OWNER / APPLICANT INFORMATION
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® OWNER: J y/ v// 4 e f%Llr/'0/2e
PHONE: CZZ - /97Z FAX:
ADDRESS:772.. f; :/fli1~1 S/7s'a0., / //e Ll%
CITY,STATE, ZIP
®CONTRACTOR: C6/-I kP £A--
PHONE:Ski 9 x,334 FAX: 5-4'9 L LZ.993
APPLICANT:
PHONE: FAX:
9Z /ADDRESS:
ADDRESS:3 12 g0,7 ea
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE # COA/Cs /0 fl4/�
CITY, STATE, ZIP
ARCHITECT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
i
PERMIT /BUILDING INFORMATION
COST OF PROJEC / '2
BUILDING HEIGHT TO PEAK:�Z
BUILDING DIMENSIONS: 6jv2 2
NUMBER OF STORIES:
NUMBER of BEDROOMS: 'r
FLANKING SETBACK:
FRONT SETBACK: JO'/
REAR SETBACK: / 7G
LEFT SETBACK: ,g„
RIGHT SETBACK: 30
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
MAIN FLOOR SQ FT/ , f YJ
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: 7 GARAGE:
CURRENT PROPERTY SIZE35 </,9 S/ �,/f COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE: '
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MANUFACTURED HOME
SIGN
WIDTH: LENGTH: C< ['%
YEAR: / /(.7 PIT SET: `�
MANUFACTURER: fiat'074
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION
FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER:
PAINT BOOTH:
FIREWORKS fr I T Y:
BLASTING:
FIRE ALARM:
TENT:
DATE /TIME:
WA STATE NON - RESIDENTIAL ENERGY CODE
PLANS EXAMINER:
ADDRESS:
PHONE: FAX:
INSPECTOR:
ADDRESS:
CITY, STATE, ZIP
PHONE: FAX:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
BOLTING °CONCRETE ® REINFORCEMENT
FIRM NAME:
INSPECTOR(S):
PHONE:
® WELDING
FAX:
BUILDING STAFF USE ONLY
1
IS PUBLIC SEWER AVAILABLE:
YES NO
IS PUBLIC WATER AVAILABLE: YES ® NO
IF YES:
® COUNTY ® CITY
IF YES, WHICH WATER DIST /IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: ® YES ® NO
IS THE PROPERTY LOCATED WITHIN ASA:
CI YES NO PSSA: ®YES ® NO
DATE:
STAFF:
METHOD OF PAYMENT:
® ® f
CASH CHECK
VISA
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BANKCARD #; EXPIRES: VIN #
AUTHORIZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
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.0•00sValley
11707 E Sprague Ave Suite 106 • Spokane Valley WA 99206
509.921.1000 • Fax: 509.921.1008 • cityhall@spokanevalley.org
Letter of Transmittal
To: Anthony
Company:
Fax: 924 -0508
From: Kathy Cummings
Dept: BUILDING DIVISION
Pages: 1
Date: 02/27/04
Re: Residential Occupancy Approval CC:
Per your request, this is to confirm that our records indicate a final inspection was
made on February 27, 2004, and occupancy approved for the permit use listed
below:
Address: 7924 East Alki Avenue
Owner: Cox / Harrolle
Parcel No.: 45183.0637
Permit No.: BLD 04 -03283
Permit Use: Double Wide Manufactured Home
Should you have any further questions, please contact this office between the
hours of 8:00 AM and 5:00 PM, Monday through Friday
Thank You
Kathy Cummings
Permit Specialist
5
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