HomeMy WebLinkAbout2003, 05-28 Permit App: BD03-523 Re-Roofzty of
POKA NE VALLEY
ox-1 OWNER
LI&
OWNER'S ADDRESS/
DESCRIBE JO
(0W- 003CP
b)( 0037
PERMIT # 0-3---373
BIDING PERMIT APPLICATION
B LOCATION 6.4ert qere3 . 1/I�i4
INS PHONE 0 j
THIS PROPERTY IS OWNED EY: SINGLE MARRIEC)
PARTNERSHIP CORP.
DX 2 CONTRACTOR'S NAME
CONTRACTOR'S ADDRESS
PHONE
DZ-8 es "21-- e CITY
CONTRACTOR'S REG.# i VCO /U 7)
(CARD MUST BE PRESENTED AND COPIED OR V ' IFIED)
EXPIRATION DATE Ds--
)X 3 CONTACT PERSON OF PROJECT
ADDRESS 6 a�-3cC ,U CITY
/X 4 SEWER AVAILABILITY -
.� - -- - WATER AVAILABILITY
ill �y O;
os�
0200S-
/X 5 ESTIMATED PROJECT COST $
X 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
PHONE
ZIP 99 AO ,Z
EXISTING BLDG. VALUATION $
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• CENSUS NUMBER LOT NUMBER___-
K 7 BUILDING SQUARE FOOTAGE Existing / proposed)
3RD FLOOR
BASEMENT UNFINISHED
CARPORT /
8, (SINGLE FAMILY ( ) NEW CONSTRUCTIO
( ) MULTIFAMILY (NO. OF UN TS N
( ). COMMERCIAL / INDUSTRIAL ) ( ) EXISTING STRUCTURE
( ) TENANT IMPROVEMENT TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE _ SQ. FT. •
OTHER /
DECK
TOTAL
1ST FLOOR /
• BASEMENT FINISHED
GARAGE
2ND FLOOR
HEIGHT TO PEAK OF BUILDING 42.2 FT.
/.5- 76
9 PLUMBING FIXTURES (Including rough -ins)
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED P“.UMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR U■ITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
- LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL:
it
10 Water Service meter size
11 Septic Tank - Not generall
Your sewer purveyor and t
12 Street use may require a "
Works Department.
,IFY UNDER THE PENALTY OF PE
ECT TO THE BEST OF MY KNOW
'E PREMISES TO PERFORM THE
Cr) / A!'.Y11-r-
f known) - Also see BOX 4
allowed in the City of Spokane Valley. For special circumstances contact
e Health District (See BOX 4)
treet Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
JURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ORK FOR WHICH THE APPLICATION IS MADE.
Thereby authorize the City of Spokane Valle to charge the fee for this permit p y g
Visa Mastercard to my credit card:
Print the name of the Holder
Expiration Date
Signature
__ ____ _____________ OFFICE USE ONLY - PLEASE DO NOT _ _______ - ____- _= _____- __ -__ -- _
- _ ________________________O WRITE BELOW THIS LINE - ________
ZONE SETBACKS:" FRONT --_______________________________________
SIDE REAR - -
PLANNING DEPARTN1ENT APPROVAL
HEIGHT LIMIT_
DISAPPROVAL
REMARKS DATE
SEPA: EXEMPT
__ ____ ___ _____ __ NOT EXEMPT
____ ___ ___ _______ _____ ______ ____ __
FIRE DEPARTMENT APPROVAL
DISAPPROVAL
REMARKS
DATE
• PUBLIC WORKS DE ====================================================== _ __ _________ _________ __ ____ ^ - -- __ -___
DISAPPROVAL
_ _______ ===========================
_______DATE
================== —._
TYPE OF JOB: NEW RESIDENCE ^_- ____ ________________ ___
RES. ADD /ALT NEW INDUSTRIAL
NEW COMMERCIAL — �_�IND. ADD /ALT
COMM. ALT /ADD NEW MULTIFAMILY
MULTIFAMILY ADD /ALT TENANT -- �__NO. UNITS
NANT IMP. ROOF
OCCUPANCY -- OTHER
BUILDING SQ. FT.
BUILDING SQ. FT.
. BUILDING SQ. FT.
BUILDING SQ. FT.
TOTAL SQ. FT.
BUILDING PERMIT N.
PERMIT FEE PLAN CHECK FEE
TOTAL FEES WSBCC SURCHARGE
OTHER CHARGES :I
BUILDING DEPARTM;NT APPROVAL
TYPE OF CONSTRUCTION
PLAN CHECK FEE REC'D
TOTAL VALUATION
RECEIPT NUMBER
PLUMBING FEE
MECH. FEE
ENERGY SURCHARGE
AMOUNT DUE
•
STORIES
ASSIGNED ADDRESS
. BY
DATE
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