2004, 09-20 Permit App: BLD-04-07694 Egress Window•• 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
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al"4631009TA=MIRED SITE INFORMATION. • •
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Street Address: 30 1,2 ststin,Q) 0 c,/,'');\ •
Assessor's Tax Parcel Number(s): • 8 3: 4e 9<v)
•Legal Description: 7 C.)Li
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-
PERMIT DESCRIPTION: ,dn ) •
Building Permit D Change in Use 0 Grading El Manufactured Home
fl Relocation EJ Tenant Improvement 0 Fire Safety
0 Other
OWNER/APPLICANT INFORMATION
D Owner: 0,),,,,,5 io pA , , L.) . 6„,
. D Applicant:
Phone: • '4.1) -0/460 Fax: . Phone: Fax:
Address: ,3 0 1.2 30,4,4'.5i,_ - Address:
‹, peo4 a ,-- (.. YR ii, -.1 t.,'4 .. 9 9.20C.
City State Zip Code City
0 Contractor: • 0);/ E.:: . 0 Architect:
Phone: : Fax: Phone: Fax:
Address: Address:
City State Zip Code • City - State , Zip Code
State
Zip Code
WA State Contractor License #: Contact:
- PER TIBU LD NFORMAT1ON
HEIGHT TO PEAK
• '
DIMENSIONS: •
# OF STORIES:, . .. .
MAIN FLOOR TO SO; FTG:
-r
*FLOOR SQ: FTG: -
.
-UNF1N BASEMENT SQ. FTG:
FINISHED BASEMENT SQ FTG;
•
GARAGE SQ: FTG: '
DECK/90V. PATIO SQ. FTG:
. .
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
•
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OFRROJECT;.;
• PI INO
•
'
3O% SLOPES ON PROPERTY:
'SEWER OR ON-SITE SEPTIC
SYSTEM?
• MANUFACTURED HOME
Width.;
Manufacturer: .
Length: Year:
Pit Set
• RELOCATION WHEN Komi Kms. win on AoomaNs
Previous Address:
Proposed Use:
REQUIRING A PERMITVCG1111. u11 __ uwG �w. ww+�c
SLEEPING ROOMS ME AMM ON CN*1EO IN SISTI 6
OWELuNGS. THE (MUMS VINT tN1A L K PROMO
war bW t
• Fire Sprinkler: # of Heads: Fire Alarm:
Tent: -
Paint.Booth:
Fireworks Display: Blasting; • •. Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address: •
Phone: • • Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State . Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE • ❑ REINFORCEMENT ❑ -WELDING
Firm Name: Phone:. • Fax:
Inspector(s):
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that 'I)- 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) ANI 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 offSpbkane 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)_
0 Cash 0 Check - d Mastercard . • ' 0 VISA • 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature: