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2003, 07-23 Permit App: BLD-03-02069 Additionof ° i1• .`e 1 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILD/NG DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: 3G moi- S L YI'LC ASSESSOR'S TAX PARCEL NUMBER(S): S.S 192. LEGAL DISCRIPTION: O r v. Acc , C, f IYV „re--) Pr FT f to 2 ' PERMIT DESCRIPTION: to' X / Q . (Iry e P dilITILDING PERMIT CI CHANGE IN USE 0 GRADING ® MANUFACTURED HOME Q RELOCATION D SIGN a TENANT }OTHER OWNER / APPLICANT INFORMATION 41 OWNER: PHONE: ADDRESS: FAX: CONTRACTOR: PHONE: ADDRESS: ® APPLICANT: PHONE: AP l l , FAX: ADDRESS: ® ARCHITECT: PHONE: TY, STA,T,EZt , FAX: L(it�'iL ADDRESS: CITY, STATE, ZIP CITY, STATE QIP ci yew WA ST CONTRACTOR LICENSE # CONTACT: PERMIT/BUILDING INFORMATION G i7 COST OF PROJECT: (6 -DO BUILDING HEIGHT TO PEAK: 2 '0 BUILDING DIMENSIONS: 1©/ X (b / NUMBER OF STORIES: NUMBER of BEDROOMS: 30% SLOPES ON PROPERTY: OCCUPANCY GROUP: CONSTRUCTION TYPE: MAIN FLOOR SO FT: 2N0 FLOOR SQ FT: UNFIN BASEMENT: STRUCTURES ON PROPERTY: FINISHED BASEMENT: CRITICAL AREAS: GARAGE: FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: REAR SETBACK: CURRENT SEPTIC USE: LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: APPROVED B1—, icC•P c Payosf- i0 x/4 Coup rPc9 y ti Long h /L/ Building Department 11707 E. Sprague #106 Spokane Valley, WA 99206 (509)688-0036 • :§:r.........,....',NW,*.., u.......,..............:....,............tu............"..u........u:........u............u..u`....:;a........ SAMPLE PLAN BULLETIN •..�u..u•..,..',.u..',u....w..va..uw.wa,,,..,...W.,.u,,........,,,..,,.u....u...,,,uu...,,..SX~..,..w.uva..weaway..w.rX.!.),\ aXJX. wMIJI.. uw...����.u�.�.�u.,uu, Scale: 1 "=20' Property corner If a water well is involved, show distances between building, sewer, septic tank, and drainfield. If there is a slope, drainfield laterals must be placed across the slope and a distribution box may be needed. Drainfield must be a mimnimum of 5 feet from property lines and/or easements. T N 1 SITE PLAN Front Street (Name) 26' 10' 29' 15' 40' Sidewalk Driveway . Distance: / t r • • • r i • I • . • 1 Patio Proposed addition 1000 -gallon septic tank minimum 10' xXXX XXXx XXXX XXXX xxxx xXXX Xxxx XXXX xxx __J 5' Minimum 4' Minimum tightline to trench trench .-_12 -•. 6' S• e. w a 1 k Perforated - . drainfield pipe 1 t r--" - Replacement lines 2 A 1 10' 15' (1) 30 iv 15' y