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2003, 07-24 Permit App: BD-03-845 DeckSbon jvalley 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 STREET ADDRESS: dcaa N. kCtN`\ 1r c( Aao,i-zon 'UDL ASSESSOR'S TAX PARCEL©NUMBER(S): LEGAL DISCRIPTION: :4131 Cw[L,k1/4( Ln • 6 eeracCes 1 LoA e OI (r3 PERMIT DESCRIPTION: c; vis a cK UIL1MNG PERMIT CI CHANGE IN USE ® GRADING ❑ MANUFACTURED HOME ®RELOCATION ®SIGN ®TENANT DOTHER OWNER / APPLICANT INFORMATION 1 OWNER: ((yy (\'(\\I ICC�MASen CI APPLICANT: PHONE: R12-1331 FAX: PHONE: FAX: �.�9.4 ADDRESS: a- N. W(i,(JVbi�y 6. ���pp(Ct6,24,7,°((° ADDRESS: (� j CITY,STATE, ZIP CITY, STATE, ZIP °CONTRACTrrOR: Nos INC. s RI Orn6crE - ® ARCHITECT: PHONE: R94 01 33 FAX: PHONE: FAX: ADDRESS: I1I 15- C. /h2"icc abvomar lsfr iA`6 ADDRESS: CITY, STATE, ZIP CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # A Idrn c -* cx"ly Qm CONTACT: PERMIT/BUILDING INFORMATION 1 COST OF PROJECT: 1 75.7).,_ 30% SLOPES ON PROPERTY: MAIN FLOOR SO FT: BUILDING HEIGHT TO PEAK: PJ OCCUPANCY GROUP: 2N0 FLOOR SQ FT: BUILDING DIMENSIONS: 10 X 1G, CONSTRUCTION TYPE: UNFIN BASEMENT: NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT: NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE: FLANKING SETBACK: 'CURRENT PROPERTY SIZE: COVERED DECK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: b X IIG I(oO Ja.Ft REAR SETBACK: CURRENT SEPTIC USE: LEFT SETBACK: CURRENT WELL USE: RIGI-IT SETBACK: IMPERVIOUS SURFACE AREA: , MANUFACTURED HOME SIGN WIDTH: LENGTH: YEAR: PIT SET: MANUFACTURER: SQ FT OF SIGN: # OF SIGNS: TYPE OF SIGN: HEIGHT OF SIGN: AREA OF EXIST SIGN: RELOCATION FIRE SAFETY PREVIOUS ADDRESS: PROPOSED USE: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: FIREWORKS DISPLAY: TENT: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE 1 PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS ® BOLTING FIRM NAME: INSPECTOR(S): ®CONCRETE ® REINFORCEMENT PHONE: ® WELDING FAX: BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: YES 0 NO IF YES: COUNTY ® CITY IS PUBLIC WATER AVAILABLE: F/ YES 0 NO IF YES, WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: YES 0 NO 1S THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: ®YES 0 NO DATE: 11 STAFF: METHOD OF PAYMENT: ® 0 CASH CHECK VISA BANKCARD #; EXPIRES: VIN# AUTHORIZED SIGNATURE' *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD 0`6 • - — r • rt"-) • fe? THESE PLANS MUST BE KEPT ON THE JOB SITE