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HomeMy WebLinkAbout2003, 06-11 Permit App: BD-03-325 AdditionCity Of SPOKANE VALLEY PERMIT # BUILDING PERMIT APPLICATION Box I OWNER /s,a �� c26!,r JOB LOCATION e COY IV Lore OWNER'S ADDRESS Z_ITYG/_eeii,tP,H�QNE��� DESCRIBE JOB A — AOrV1749>�9Yr� THIS PROPERTY IS OWNED BY: SING L /MARRIE PARTNERSHIP CORP. ----------------------------------------- ----------------------------------------------------------------------------------------- BOX 2 CONTRACTOR'S NAME Ui.d S /7e !A�__l PHONE, ?? d�s3 CONTRACTOR'S ADDRESS / &Y /1° Movie ttf1t-rct2,7 4�-Z-�Y CITY /�/� t�>����Zi� • G-��P CONTRACTOR'S REG.# z9A52,f- EXPIRATION DATE 0i:�,1105 (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) ----------------------------------------------------------------------------------------- BOX 3 CONTACT PERSON OF PROJECTPHONE ADDRESS CITY ZIP ---------------------------------- BOX 4 SEWER AVAILABILITY ,uES WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $ ----------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------- BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER ----------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------- BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOR_/2ND FLOOR / BASEMENT UNFINISHED CARPORT OTHER / TOTAL BOX 8 (k') SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL/ INDUSTRIAL (x) TENANT IMPROVEMENT BOX 9 PLUMBING FIXTURES (Including rough -ins) DECK BASEMENT FINISHED GARAGE HEIGHT TO PEAK OF BUILDING FT. ------------------------------------- ------------------------------------- ( ) NEW CONSTRUCTION () EXISTING STRUCTURE TOTAL AREA OF PROPERTY SQ. FT. IMPERVIOUS SURFACE SQ. FT. ---------------------------------------- ---------------------------------------- MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. ---------------------------------- BOX 10 Water Service meter size (if known) Also see BOX 4 BOX 11 Septic Tank — Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT '1DATE 6- --// C� (OVER) =y,Oe fir. P6Ine, 11707 E. SPRAGUE, STE 106 ;�O%,I-IeYSPOKANE VALLEY, WA 99206 (509)688-0036 FAX(509)688-6037 SITE INFORMATION Site Address: 10� Parcel Number: Subdivision: rte e"'cicre-L—, Block: 2 Lot: Zoning: Water Dist: Owner: KI -J, N ! cb"� t I a,S Address: ON Q Building Inspector: PROJECT TRANSMITTAL: TRANSMITTAL DATE: PERMIT INFORMATION Permit Number: ,3 Issue Date: Permit User l�.�S`f`er'l'ooe Applicant: Phone: Contact: LLCYSY)ck rst , Phone: Contractor: Setbacks — Front: Left: Right: - Rear: APPROVALS DIST= WATER DI STO ATER: APPROVALS 1900 It o.67 Q C�. �z 4144, A, L -L t,4/+ -r A � 0, E L- -ti F- 4 I2©, 8 e" — I — I v v E p- 12- 1211 C., il'e 01/ t4 APPROV01) y I 111 APPROVED Br, lov—