Loading...
2002, 04-23 Permit App: 02002890 Reroof2 110111 SPOKtN COON IY Zto ,'. PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: Zg© Assessor's Tax Parcel Nurnber(s): Legal Description: Project Description: r6�+ 'fir i ilding Permit O Relocation O Change in Use •O Grading O Manufactured Horne Permit O Sign 0 Tenant (New/Change) O Other Department Use Only Wale( District/Pun•eyor School District Sewer District/Purveyor Fire District: Front: " Left. • 'Rear: Right-. OWNER/APPLICANT INFORMATION 0 India.* who .boald br i oniaded rrourdrn� thir /rojre, 0 4}A. nrr: Phone: + �r > — 1 ! 0k rjt/ii-i-" n %./. �4m�j�y/�— Fay: J1 /h S/! 0 Applicant: Phone: Fav: Mailing AJdress:hlailing 1-714 -41,5- Addles,: Dim,. rasions City, State, Zip /71 k ,Pk4 i arm W739... 9271 City, State, Lip Finished basement sq. 0. Cnnvacr.0 Phunco {/ �l`�/ f"a� ❑ Architccti Engineer PhonC Far Mailing, address Mailing address Ic-at sourer (electric_ gas, etc) City, Stare Zip _ City, Stltc 7.ip \VA State t:.rntraci.x license k Contact name: • PROTECT INFORMATION Building Information Building height ilk teak # of stunt.. ;lain floor sy. ft. Vntiru hcd basement sq. 0. Dim,. rasions "1.ttai habitable sracc 2..4 floor sq. ft. Finished basement sq. 0. Occttpancc group Construction nrr - Garage :y. ft. Deck sq. fr. Gust of (rul,I 7 11g0 Ic-at sourer (electric_ gas, etc) Manufactured Home Sign . Width: Length: What is the square footage of the sign face? How high is the sign? Year. Make: # of signs Area of existing signs _ Proposed use Value Relocation- Fire Fire Safe I'inn Name " Precious address Will the site be served be a septic system? 0 Ycs 0 No Paint booth Fire Sprinkler Tcnt Fireworks display ^ Fire r\lann _ Proposed use Value Special.Inspections: Requited? lion -Residential Energy Code Compliance? I'inn Name What is the current use of this property? Phone Will the site be served be a septic system? 0 Ycs 0 No Plans E.caminer Phone Inspectors: is there evidence of Fill or excavation on the property? 0 Ycs 0 No Arc there slopes greater than 30°'0 on the property? (30 ft rise in 100 ft) ( _- %) CI Ycs 0 No .1re critical or hazardous materials used or stored on site? 0 Ycs 0 No Address Inspector Phone 0 Concrete 0 Welding 0 Bolting 0 Reinforcement • Address ADDITIONAL SITE INFORMATION ,1rc there structures on the property? 0 Ycs 0 No If yes, idtnqf an silt plow 11C7tat is the current property siic? (square feet or acres) Is any pan of the property within 250 feet of a shoreline? If yet. Marlin, on sit, plan 0 Ycs 0 No What is the current use of this property? Is your properry in a designated wildlife habitat arca? 0 Don't know 0 Ycs 0 No Will the site be served be a septic system? 0 Ycs 0 No is any part of the property within a 100 yr flood plain? lbw, ident6, on alit plan 0 Maybe 0 Don't know 0 Ycs 0 No Are or will there be wells located on the propery? If yer idadi o i the silt plan ❑. 1'cs 0 No .. Are there any wetlands, streams or ponds within 200 feet of the property? If yes, iffentyy on site plan 0 Yes 0 No is there evidence of Fill or excavation on the property? 0 Ycs 0 No Arc there slopes greater than 30°'0 on the property? (30 ft rise in 100 ft) ( _- %) CI Ycs 0 No .1re critical or hazardous materials used or stored on site? 0 Ycs 0 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Conrrol Arca? ❑ Yes 0 No Is public sewer available to the site? 0 Yes 0 No Is the property inside the ASA? . 0 Yes 0 No 0 Ycs 0 No Is public water available to the site? 0 Ycs 0 No Is the property inside the PSSA? 0 ,Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? O Ycs 0 No t).,teRccenr•d: Sof( Its prr„ntatise: METHOD OF PAYMENT VISA ❑ (:_\�11 ❑ rI Iwo; ❑11=1123❑ . DiJCYUEF FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD D:\"I"i?: 1:N Plltl•:S: ti:\NK(:.\RI) NllNIBEIt: _\UI.11O1217.1.•:I) Sl(iN.1 1.111.1.: 'l'I3•I O•I..11. TOTAL FEE MINIMUM PERMIT FEE IS SJS. 00I'LC..tztE NO I: P. (:IBECKS P_\Y.\IR. '1'U SI'01:A\I: COUNTY PERMIT CENTER