2004, 08-10 Permit App: BLD-04-07333 Change of UseL 11 (
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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: J\ t 4 , .—FDpc:r- ye
4 -Assessor's Tax Parcel Number(s): /44-2 e 3 T 0/
Legal Description: l " ca474011 ?IC) i/ �' �r<�4 f -r} N et.7 !s L 1 2
PERMIT DESCRIPTION: - - H 3-QYv -2Y .� o
D Building Permit
❑ Relocation
Change in Use ❑ Grading ❑ Manufactured Home
El Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
PnaY(J
Owner: Yn-CrlOh! i� I. �'.�1� pphcant:
Phone: c2c1 Fax: — Phone:
Address: \ OIe �, - e , Address:
,1<;,V'Ocay. ClCit (1(p
` ` State Zip Code City State Zip Code
❑ Contractor: El Architect:
Fax:
Phone: Fax:
Address:
City
State
WA State Contractor License #:
Zip Code
Phone: Fax:
Address:
City -
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:il-T OD
2' FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/GOV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
0 BOLTING ❑ CONCRETE
Firm Name:
0 REINFORCEMENT
Phone:
Inspector(s):
Fax:
0 WELDING
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 full 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 permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard).
❑ Cash 0 Check 0 Mastercard ❑ VISA 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature:
i17/43 )rory
-6,1-70t %en7
01- -1-41, time evite 44
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A
EMERGENCY MESE NEGUINEMENTS
FROM SLEEPING SOONG
I) NET CLEAR OPENING: 5.7 SQUARE FEET
GRADE FLOOR OPENING (IAX 4e) 5.0 SQUARE FEET
2) NET CLEAR OPENING HEIGHT 24 INCHES
3) NET CLEAR OPENING WIDTH 20 INCHES
4) MAX FINISHED SILL HEIGHT 44- MOVE FLOOR
5) EMERGENCY ESCAPE & RESCUE OPENING SHALL*
OPERATIONAL FROM THE INSIDE OF THE ROOM WITHOUT
THE USE OF KEYS OR TOOLS
Scotto* 01 port
Spokane
CHANGE OF USE
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Job Address:
Description:
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
14106 E BOONE AVE
SPOKANE WA 99216-1972
CHANGE OF USE FROM R-3 TO LC ADULT FAMILY HOME
(5)- LEVEL I CLIENTS / CHANGE GARAGE TO STORAGE
CURTIS, MERLON R & MARY ELLEN
CURTIS, MERLON R & MARY ELLEN
14106 E BOONE AVE
SPOKANE, WA 99216-1972
Lot: Blk:
Phone:
Phone:
Lic No:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #: BLD -04-07333
Applied:
Issued:
Expires:
Parcel No: 45142.3401
Zoning:
08/10/2004
08/10/2004
02/06/2005
General Information:
USE CLASSIFICATION
R-3 TO LC
Fees:
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits/Receipts:
Total Due:
47.00
4.50
51.50
0.00
51.50
THIS IS NOT A RECEIPT
1,,A; ,N Citilu.ti 3/301
44,0-1
08/13/2004 07:36 5093241567
AUG 10 2004 16:20 FR
SRHD EHS
leY CHANGE OF USE
11707 E. Sprague Ave,,, Suite 106
Token Valley, WA 91x208
Job Address:
Dasarlption:
3ubdivlslon:
Owner:
Applicant:
flddres«:
Contractor.
Address:
14109 E BOONE AVE
SPOKANE WA 99216-1972
CHANGE OF USE FROM R-3 TO LC ADULT FAMILY HOME
(5)- LEVEL 1 CUENTS / CHANGE GARAGE TO STORAGE
TO 3241567
PAGE 01/01
P.01/02
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application # BLD -04-07333
Applied:
Issued:
Expires:
Lot: Bik: Parcel No: 45142,3401
CURTIS, MERLON R & MARY ELLEN
CURTIS. MERLON R & MARY ELLEN Phone:
14106 E BOONE AVE
SPOK NE, WA 99218.1972
Phone:
LlcNo:
Zoning:
0811012004
08/10/2004
02/0e/2005
3sneral Information: Fees:
,JSE CLASSIFICATION R-3 TO LC BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits/Receipts:
Total Due:
47.00
4.50
51.50
0.00
51.50
This IS NOTA RECEIPT
01 11-7, 1 2GIGtd c: R: --R
5093241567 PAGE.01