2003, 09-11 Permit Application: BLD-03-02445 Egress WindowPERMIT
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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:
(-- -(K /0 3 0-5
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: (ems
BUILDING PERMIT El CHANGE IN USE 0 GRADING
® SIGN QTENANT
® RELOCATION
MANUFACTURED HOME
0 OTHER
1 OWNER / APPLICANT INFORMATION
1
® OWNER:
PHONE: FAX:
ADDRESS:
r ,^ %CITY,STATE, ZIP
/CONTRACTOR:/4Z17 / I / ` V ' C% / 0 ARCHITECT:
PHONE: 50 c e.). -Y `// / AX: ((./ t 7 ` �/ PHONE:
ADDRESS: t G)o 1 " �
� TMl STATE, ZIP ADDRESS:
WA ST CONTRACTOR LICENSE # CONTACT:
® APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
FAX:
CITY, STATE, ZIP
/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
OCCUPANCY GROUP: 2N0 FLOOR SQ FT:
CONSTRUCTION TYPE: UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: GARAGE:
CURRENT PROPERTY SIZE: COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
1
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN:
# OF SIGNS:
TYPE OF SIGN:
HEIGHT OF SIGN:
AREA OF EXIST SIGN:
RELOCATION
FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER:
PAINT BOOTH:
FIREWORKS DISPLAY:
BLASTING:
FIRE ALARM:
TENT:
DATE /TIME:
WA STATE NON - RESIDENTIAL ENERGY CODE
PLANS EXAMINER:
ADDRESS:
PHONE: FAX:
INSPECTOR:
ADDRESS:
PHONE:
CITY, STATE, ZIP
FAX:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
0 BOLTING CI CONCRETE ® REINFORCEMENT ® WELDING
PHONE: FAX:
INSPECTOR(S):
FIRM NAME:
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: ® YES
® NO
IS PUBLIC WATER AVAILABLE: 0 YES 0 NO IF YES, WHICH WATER DIST /IRR:
IF YES: 0 COUNTY
® CITY
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES 0 NO PSSA: 0 YES 0 NO
DATE:
METHOD OF PAYMENT:
CASH
1
STAFF:
CHECK
'VISA
BANKCARD #; EXPIRES: VIN #
AUTHOR /ZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
1