HomeMy WebLinkAbout2002, 08-07 Permit App: 02006756 PoolI h I
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SPOK KE Cowry
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, \VA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
/%y l / S. Cent RJ.
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
�h pew* cl:1-53//in 11
a Building Pcmdt
a Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
0 Sign
O Tenant (New/Change)
O Other
art<iene _.
trDe
Phone:
Pas:
Mailing Address:
/2 /7 — (;,,t;1 C),
Mailing Address:
.
City, 'Marc, Zip
Ven 44 "k"4 97/05d3 7
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Water Dist ct/Pu-ey
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OWNER/APPLICANT INFORMATION
0 Indira/e who should be rant rerd rcpnnlin•• /hi. h,vh ;
0 avnur Phone: Q . V g2?— 954,L
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Lmli..-;:c101
Phone:
Pas:
Mailing Address:
/2 /7 — (;,,t;1 C),
Mailing Address:
Dimensions
City, 'Marc, Zip
Ven 44 "k"4 97/05d3 7
(:in.. S tan.. Zip
. • ..
.,ter
7 (/mluracr r// / ..1_ ��P(jh''unc(2?f) 3'?p„3 0 /
/9—/ Ueihel a/ antdia K, Lax q)3z9. 5772—
0 A rdt iia t/Iingneur
Phone
Fax
hlailing address
6 W /V• .0)/A10—es..—
oKro-e_Cine,
Marling add Toss
I lent Unice (olectric. gas, etc.)
Cite,Stair Zip
.S .o k se Vat --12f 2O 1
City, Stat Zip
WA Star Conuaaor lironse i%
'
t:ontnct name
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PROJECT INFORMATION
Building Informarion `
Building height to peak
# of stories
,\Iain floor sy. it.
Unfinished basement sq. ft
Dimensions
'Total habitable space
2'"l hour .<y. It.
Finished basement sy. ft.
Occupancy group
Construction type ..
Garage sy. ft. :
Deck sy. Ft. ..
Cost of pmiect
I lent Unice (olectric. gas, etc.)
-.. ..... _ ,
Mahufacturedfliirit;;;;-:-:.'' ' :,:iff,,,,..fitr,.i
Si.0.-6 '',.-..;-:. .;.• , "r•-•:'••••-ic:-,,,,r---sve ‘C%"..Y . .7 Co 4; ,:ro,:s...'" -2 ' •../<....t.',:f.
Width:Wh0--
Length:
at is the square footage of the sign
face?
• ' '
How hii., is C Sign. 1th ?
, .
Year:
Make:
# of signs
Arca of existing signs
. \ re there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes CNo .
Proposed use
Value
Phone
Relocation:.. , - , ‘ :....1., WW:t41':':
Fiife,Sa'fdiv:5,::.4.M.Aenkc,.2",
d.t.jet.' j ''''P 2 i ''' a c:1 V Ift'aV?..aqiihjcS4k ':ti'.1.11N..iethlit*%i'.4),&
Previous address
Phone
Paint booth
Fire Sprinkler
Tent
_
lire Alann
Fireworks display
_
. \ re there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes CNo .
Proposed use
Value
Phone
0 Concrete
0 Welding • 0 Bolting 0 Reinforcement ,
Spectal InspettionOtequite I. ,. ' k ..
. N. on-'llesiddh6aclitilagyM"'t-bae%C. Osniphan(eR514,,.:",*,-)
Firm Name
Phone
Plans Exrunincr
Phone
Impectors:
Arc or will there be wells located on the property?
If.yes, ideneell on fie site phm 0 Yes IS No
Addass
Is lime evidence of till or excavation on the property?
0 Yes 211. No
. \ re there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes CNo .
Are critical or hazardous materials used or stored on site?
0 Ycs R No
hispecrin-
Phone
0 Concrete
0 Welding • 0 Bolting 0 Reinforcement ,
Add,„,
ADDITIONAL SITE INFORMATION
Are there structures on the property? rir Yes 0 No
If yes, identift on site plan
What is the current property size?
(square feet or acres) . • - -
Is any part of the properry within 250 feet of a shoreline?
Inn. Nem% on sue plan 0 Yes tic No
What is Elle current use of this property? g ti - i
/) .e%•dei
Is your property in a designated wildlife habitat arca?
0 Don't know 0 Ycs a No
Will the site be served by a septic system? 0 Yes + 0 No
Is any part of the property within a 100 yr flood plain?
kw, Melded)on sue plan
0 Maybe 0 Don't know 0 Ycs C3 No
Arc or will there be wells located on the property?
If.yes, ideneell on fie site phm 0 Yes IS No
Are there any wetlands, streatns or ponds within 200 feet of the property?
If yes, idenlify on .rile ph») 0 Ycs 2 No
Is lime evidence of till or excavation on the property?
0 Yes 211. No
. \ re there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes CNo .
Are critical or hazardous materials used or stored on site?
0 Ycs R No
DEPARTMENT USE ONLY
Is the property in a designafildStormWter Control Area? "- ?";',-;4••;;;;:-.1,,:'-' .
• ....: .":'•:-'....':;•?:". .1.- : .—L.: 13:'-Ycs- :.0::.b•fd:stt2...?1:.'
I
- Is public sewer available to tliO site? !i.,.0ti
':•‘:-i.V111-'.':ri:65;1';i::::,tVbIZtirtin?,ttg:';-ttf.
Is the property inside thASA?
••• : ••••••Z"--
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'Is public water available to the site??:::- '-'2'••::-. '--';0.Wi-,,?:1:1?Nii-::::-firgrz:1
' • ' " '''' ?--:-.Zt."-:. a ''Cr
Is the property inside the PSSA?'
-
. '
•
.0 Yes 0 No
Is the property located within:1000'feet '1-(f INaimial/RSOuigg'Aica?..ig4.4./,'
)are Rectsvcd:
Stall Reruminative:
METHOD OF PAYMENT
EM!Cli
VISA
LI cAsi criNcK 0 EMSZMI31 0 0
'DISCOVER
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trzcautrisi
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
EX 1,112ES:
BANE:CARD NUNIBRR:
LI•11101t1'/..ED SIGNA'1•LIRE:
StiliTCYFAI.
i t ;C:-.. ''''' "' " ' TOTAL FEE
AHAVIMIX1 AERAIIFFEE le razooplini .
MA KE CI IECKS PAYABIE TO SPOKANE -;-
:- . : 7',COCNIA' PERMI1 CLISI ER
ADDRESS !/a_3jaeuT .
ROAD WIDTH 50
FRONT MI NKING
COMM S
REVIEWE
>50 '
> do,
eoJrey Snipe
/217 S. Cent -4 Ra.
Vera oi��c VA ??°fl
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