2003, 09-29 Permit Application: BLD-03-02610 Detached GaragesokstrneN...,
jValley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688 -0036 Fax: (509)688 -0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
S_ 44
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
DUILDING PERMIT l CHANGE IN USE a GRADING
® OCATION
® SIGN ® TENANT
® MANUFACTURED HOME
0 OTHER
OWNER / APPLICANT INFORMATION
® OWNER:
� t 14/14z-bu4e _
PHONE: g!( Z` /a5b FAX:
ADDRESS:
CITY,STATE, ZIP
°CONTRACTOR: 4-/ (:_if re-i.-"C ii ii a Li
PHONE:
ADDRESS:
CITY, STATE, ZIP
FAX:
WA ST CONTRACTOR LICENSE #
APPLICANT: _)I-I (7fi ; eL noc1
PHONE: 9/_.)" 1/��--- FAX:
ADDRESS: 4 ?/ /(=
CITY, STATE ZIP
® ARCHITECT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT /BUILDING INFORMATION
^� �_,
COST OF PROJECT: % / 30% SLOPES ON PROPERTY: /C,C��
BUILDING HEIGHT TO PEAK: f4 OCCUPANCY GROUP:
BUILDING DIMENSIONS: 2 -4 >ZZ- �" CONSTRUCTION TYPE: 1:20.
NUMBER OF STORIES: STRUCTURES ON PROPERTY:
NUMBER of BEDROOMS: f CRITICAL AREAS:
FLANKING SETBACK: CURRENT PROPERTY SIZE:
FRONT SETBACK: CURRENT PROPERTY USE:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT:
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
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 DISPLAY:
BLASTING:
FIRE ALARM:
TENT:
DATE /TIME:
i
WA STATE NON - RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
BOLTING ®CONCRETE
® REINFORCEMENT ® WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
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: 0 YES ® NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO
DATE:
1
METHOD OF PAYMENT:
PSSA: ® YES ® NO
1
STAFF:
CASH CHECK
BANKCARD #; EXPIRES: VIN #
AUTHOR /ZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
1
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