2004, 08-30 Permit App: BLD-04-07509 Pole Building*lan
.00Ualley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION - •
Street Address: (00Z-
Assessor's
0UZ-
Assessor's Tax Parcel Number(s): •
7b) 1 9 004 j12)( .Z'
Legal Description: P/e PERMIT DESCRIPTION: Lit.-Y(o ,• 141 f I Ul(rc, t v\./
4,1 Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
j[1 Relocation [1 Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: 1 l or VA_,„qe Card
Phone: QZe. I S Fax:
Address: (o2 PeirJ(
id<
Zip Code
a r� ! .
ty State II
Gonnta tor: Vele CON't c,LctnrS
Phot�� "j ZS -ZO 44 / Fax:
Address:
aoeu pa
City 1
.0 j .-
d
�� cyq,ZZ
State Zip Code
❑ Applicant:
Phone: Fax:
Address:
City State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
WA State Contractor License #: V/a L-k1d M5 Contact:
State Zip Code.
()A C4 -4J
e
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK,
(q
DIMENSIONS:
gO)<110Kai 1 (2 (eea!!
# OF STORIES:
l
MAIN F,LOOR TO SQ. FTG:
1103 f 4030 /GBO
2mu FLOOR SQ. FTG:
UNFIN BASEMENT SO. FTG:
FINISHED BASEMENT SQ FTG:
GARAGE SQ: FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE: nD /e .
(
HEAT SOURCE:
# OF BEDROOMS: •
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT://
'(/`1%){0
30% SLOPES Oil PROPERTY:
//c)
SEWER OR 01•I -SITE SEPTIC
SYSTEM? r)pp-{rr
MANUFACTURED HOME
Width; Length: Year:
Manufacturer:
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent:
Fireworks Display: Blasting:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
Date/ Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone: • Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State Zip
SPECIAL INSPECTIONS
❑ BOLTING D CONCRETE 1 1 REINFORCEMENT D WELDING
Firm Name:
Phone:.
Inspector(s):
Fax:
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done In futi compliance with the City of Spokane Valley Development Code.
-Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued piaure to th
Print Name ! 1pi/ L
�rt"a I P� Signature
i•ro•e
y owner.
Method of Payment: (Faxed permit applications will only be accepted with major bankcard).
❑ Cash ❑ Check ❑ Mastercard
Bankcard #: Expires: VIN#:
Authorized Signature:
VISA ❑ Other
spoltan�ane
valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
ACCESSORY BUILDING
Job Address: 602 S BARKER RD
GREENACRES WA 99016-8781
Description: 30 X 40 POLE BUILDING W/12 X 40 LEAN-TO
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
SHEPARD, NORMAN
VALLEY CONTRACTORS
42100 N DEER MEADOWS DR
DAVENPORT, WA 99122
VALLEY CONTRACTORS
42100 N DEER MEADOWS DR
DAVENPORT WA 99122
Lot: Blk:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD -04-07509
Applied:
Issued:
Expires:
Parcel No: 55191.0631
Phone: (509) 725-2044
Phone:
Lic No:
(509) 725-2044
VALLEC`101KS
Zoning:
08/30/2004
02/26/2005
General Information:
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
30000
19
42 X 40
1
100+
95
40
13
u-1
5-n
2
100 X 319
yes
no
Fees:
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits/Receipts:
Total Due:
441.75
4.50
446.25
0.00
446.25
THIS IS NOT A RECEIPT
08/30/2004 69:27 i v c.l r r 50932567 SRHD EHS
.--+v-. 41 z
11707 E. Sprague Ave_, Suite 106
Spokane Valley, WA 99205
PAGE 01/01
TO 3241567 P.02/03
ACCESSORY BUILDING
Job Address: 602 S BARKER RD
CRF=ENACRES WA 99016-8781
Description; 30 X 40 POLE BUILDING W/12 X 40 LEAN-TO
Subdivision:
Owner:
Applicant,
Addross:
Contractor:
Address:
SHEPARD, NORMAN
VALLEY CONTRACTORS
42100 N DEER MEADOWS DR
DAV/ NPORT, WA 98122
VALLEY CONTRACTORS
42100 N DEER MEADOWS DR
DAVENPORT WA 99122
THIS IS NOT A PERMIT
Penalties will ba assessed for
comm!►ncing work without a permit
Application 0: BLD.Q4.07509
Applied:
Issued:
Expires:
Lot Blk: Parcel No: 55191.0031 Zoning:
Phone: (509) 725-2044
Phone: I (509) 725-2044
Lia No: VALLEC'101KS
08/0/2004
02/2612005
Aanoral Information'
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC 8Y9TEM
WELLS LOCATED ON PROPERTY
30000
19
42X40
1
100+
96
40
13
u-1
5-n
2
100X319
yes
no
Fees:
BASIC PERMIT FEE
WSBCC SURCHARGE
TotQl Calculated:
Deposits/Recolpts:
Total Due:
441.75
4.50
446.25
0.00
446/5
THIS IS NOT A RECEIPT
AUG 30 2004 10:30
5093241567 PAGE.01
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Signed:
Dale.