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2003, 09-19 Permit App: BLD-03-02515 MH.00Valley 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 L L STREET ADDRESS: /"&/ ,'V?) K7h j74,64 QS 47./2P ASSESSOR'S TAX PARCEL NUMBER(S): 56'0 ,53 ©�Z LEGAL DISCRIPTION: ZO f /U how. ,ark PERMIT DESCRIPTION: o/ "52oeefelA , hdeA O BUILDING PERMIT 0 CHANGE IN USE 0 GRADING ,MANUFACTURED HOME D SIGN D TENANT ORELOCATION BOTHER OWNER / APPLICANT INFORMATION ° OWNER: i///e APPLICANT: /C iafr(-MGisolil PHONE: FAX: PHONE: �y % T 3`/2 FAX: Say 7Z7-('7 S7 ADDRESS: «7/ D7 S, E /%7T n 5-- ADDRESS: /Sy/S - f?�/,et Zvi Y7,03 2 CI ,STATE, ZIP CITY, STATE, ZIP °CONTRACTOR: ° ARCHITECT: 11i4 PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: BUILDING HEIGHT TO PEAK: /5//-t- BUILDING 5/'-tBUILDING DIMENSIONS: Z7/ SZ. NUMBER OF STORIES: / NUMBER of BEDROOMS: 3 FLANKING SETBACK: FRONT SETBACK: REAR SETBACK: LEFT SETBACK: RIGHT SETBACK: /v1 30% SLOPES ON PROPERTY: XU MAIN FLOOR SQ FT: OCCUPANCY GROUP: 2ND FLOOR SQ FT: CONSTRUCTION TYPE: UNFIN BASEMENT: STRUCTURES ON PROPERTY: FINISHED BASEMENT: CRITICAL AREAS: A)) GARAGE: CURRENT PROPERTY SIZE: COVERED DECK: CURRENT PROPERTY USE: VQ ezhH-(- DECK: CURRENT SEPTIC USE: CURRENT WELL USE: /)0 /019 IMPERVIOUS SURFACE AREA: MANUFACTURED HOME SIGN WIDTH: Z 7 LENGTH: 7 Z. YEAR: '2003 PIT SET: x MANUFACTURER: Z-,;1.4 Ti SQ FT OF SIGN: HEIGHT OF SIGN: # OF SIGNS: AREA OF EXIST SIGN: TYPE OF SIGN: RELOCATION FIRE SAFETY PREVIOUS ADDRESS: PROPOSED USE: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: ADDRESS: PHONE: FAX: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS O BOLTING FIRM NAME: INSPECTOR(S): ®CONCRETE 0 REINFORCEMENT PHONE: 0 WELDING FAX: BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: 0 YES 0 NO IF YES: 0 COUNTY 0 CITY IS PUBLIC WATER AVAILABLE: 0 YES 0 NO IF YES, WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: 0 YES 0 NO DATE: STAFF: 1 METHOD OF PAYMENT: O O CASH CHECK BANKCARD #; EXPIRES: VIN# AUTHOR/ZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD ' _ JJJJJ 2 c - 'W •,11 JJJ Jam, • JJ JJ_ -- •JJ JJJJ JJJJ ; S _1._T_i; •-i •1 I 11) -1411 -WW:- !!} ts� A a IiA*s sews 11 *�*s •••••►ssf • . , es Leine