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2003, 12-01 Permit App: BLD-03-03170 Play Pavilion
S"p®kan° ems' #Malley G?r 3' 70 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 . Spokane Valley, WA 99206 Phone: (509 688-0036 Fax: 509)688-0037 REQUIRED SITE INFORMATION 1 STREET ADDRESS: 3 A 1 ( S ASSESSOR'S TAX PARCEL NUMBER(S): FD,( CQJCkc S?zic4n)f OcJ(e, WA 542D6 S lj 4533( / CSos LEGALDISCRIPTION: Int Icl l l7MQ I'- civacick_rcw Lot 51 3(n, lc PERMIT DESCRIPTION: SBUI,DING PERMIT 0 CHANGE IN USE 0 GRADING ®RELOCATION 0 SIGN 0TENANT 0 MANUFACTURED HOME ® OTHER OWNER / APPLICANT INFORMATION ® CONTRACTOR: OWNER.5 }p%c4 J Zo.SS 1 st,Ati, rk.,,,b;aSaJ PHONEQ OSJ 52:7-L( 55 FAX: Dr -i---. -.,,,-- a- PHONE: Sh^^l-` ADDRES .l 5. Or. 5p1L Il Y( 3 6 ADDRESS: SR- 4 -IR CITY S • TE, ZIP ki toe, APPLICANT: 5 LI 'L'k 01),4-S Or) PHONE: FAX: ADDRESS: CITY, STATE, ZIP ® ARCHITECT: PHONE: ADDRESS: WA ST CONTRACTOR LICENSE # FAX. SITYY CITY, STATE, ZIP FAX: CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: I V, S oD BUILDING )EIGHT TO PEAK: 2-1 tL{K X, gj IO'Xla' BUILDING DIMENSIONS: NUMBER OF STORIES: 1 • NUMBER of BEDROOMS: C� FLANKING SETBACK: FRONT SETBACK: REAR SETBACK: LEFT SETBACK: RIGHT SETBACK: • 30% SLOPES ON PROPERTY: OCCUPANCY GROUP: CONSTRUCTION TYPE: STRUCTURES ON PROPERTY: CRITICAL AREAS: CURRENT PROPERTY SIZE: CURRENT PROPERTY USE: CURRENT SEPTIC USE: CURRENT WELL USE: IMPERVIOUS SURFACE AREA: 4/Pr 1 MAIN FLOOR SQ FT: `2.2_B 2ND FLOOR SQ FT:=S- UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: COVERED DECK: DECK: N Pr /d' aGcL +-� bukka �ncC 7°tfl. Smanne ,So*r/oe A+o%"s✓rr /3/ 9®0 PLANNING DEPT. APPROVED 39 ."1 0 ALA -(71a5 Or r l D1 / r 311/b S. Fox Cr. �a t- Sall/14c Fore, A-PPmox'.wn g /3, 900 /,Pecaa'Ar X MAK /►U LAM but,. exV-e,,e- , n U - 3. S` ac z& c. 15 2: Cl 9k 544404 40 `1&h1vE• a ji14'fA r3 o" up' 8it 'PATIO DOOa i-WMt rlv1 13AMBoo Qci 144 ,UJ i t P 4/0).16,.5Vtd\ w/ lriR 6 R • JNn12: TlMi3CR 12>r-fikIUSN(,1 61AR Jo 1110102 -4IMiT6 of 1trtOpf ppb At,Y feYA'f l,o N NOR'fl-t 1rfikf Inw 11M ER 12E1"Aigi k 16444614,4, hA AAA cu -Le a. tLektAz'k ,1/4404t THE�F P ui OIC N1-11 r3-1R01zd©F\KiL . Set FE Iff 'FAf 11r tt4 Tuat1 T�Lz Cb)UU4 gi12 K IL/Z" I�Au J at 'R-16) I�1SI,l4ATIoN !IL" 415512oCtZ -4 4,1ZEf''E, cowl `r -tit EX'f• 411;111,41 '�pItiRMA L v.( RAP 2kl," fkAMIOC? 2.l4•t• 4008 RuAK1 SCALE: It&i ,: 1 1... " DATE: lot 0177 Cl j DRAWN BY`,-, REVISED 114,70-5 •DRAWNB NUMBER • -4Z PRINTED ON NO. 100011 CLEARPRINT•