2003, 06-10 Permit App: BD-03-308 Garage.Tor _r
e 11707 E. SPRAGUE, STE 106
IVB eJ SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMITTAL:
TRANSMITTAL DA'Z'E:
PERMIT INFORMATION
Site Address: / / f td in
Parcel Number:
Subdivision: A,-
Block: Lot: ,2 j
Zoning: Water Dist:
Owner: Ca r a) �o���r ` ,5 .
Address: / e h
Building Inspector:
BUILDINGS:
PLANNING:
Permit Number: 300-3 -3Oilssue Date:
Permit Use: 4,eD -e
Applicant: 3 (ct,Q s (<4.45
Contact: JV7r9 Sc,7r„//,
Contractor:
Phone: ,.•.
Phone:
Setbacks — Front: Left: Right: Rear:
APPROVALS
e4/fritilA. (0/0/0 3
ENGINEE
HEAL 1 " :
SE` R:
DISC
APPROVALS
sty of
'OKANE VALLEY
x-1 OWNER (skro k L'o)
OWNER'S ADDRESS S�
(ow- 003 (p
ira)( 0037
PERMIT #
BDING PEI2NIIT AppI,ICATION
DESCRIBE JOB C,cAna.t .�
JOB LOCATION ICO Co IAA • n?
CITY PHONE
e���41c
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED Gi n yt -4--
PARTNERSHIP CORP.
X 2 CONTRACTOR'S NAME '-Ive C
�-. PHONE 201( GS9 $Z 4 9
CONTRACTOR'S ADDRESS `.703q N. Ccr'r•e IZ)• CITY
i
�.� � 7P ?3t 7
CONTRACTOR'S REG.# 1 j1 0,SL--4 C1,1%, E,ci EXPIRATION DATE
-----------------------------------------------
(CARD MUST BE PRESENTED AND COPIED OR VE�IFIED) -----------------------------
(
--_(3 CONTACT PERSON OF PROJECT .p`,,,,k .Seco. (o PHONE Cosq _ Q�(4 q
ADDRESS 27031 k) Civr.e 1) CITY Sp, r. L Lx_ lb ZIP 111 '1'
4 SEWER AVAILABILITY
WATER AVAILABILITY
:5 ESTIMATED PROJECT COST $ J, dac) EXISTING BLDG. VALUATION $
---------------------
6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMITA SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• CENSUS NUMBERr
LOT NUMBER
7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR /
BASEMENT UNFINISHED
OTHER
CARPORT / TOTAL
1ST FLOOR
/ BASEMENT FINISHED
DECK
( ) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UN
( )• COMMERCIAL / INDUSTRI,
(--) TENANT IMPROVEMENT
-
TS
)
PLUMBING FIXTURES (Including
PLEASE USE THE ATTACHED P
SYSTEMS, HEATING AND AIR U
LAWN SPRINKLER SYSTEMS, B�
2ND FLQOR / •
/ GARAGE 2 2 LI
HEIGHT TO PEAK OF BUILDING 11--, FT.
( >) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
. TOTAL AREA OF PROPERTY SQ FT
• IMPERVIOUS SURFACE_ I SQ. FT. •.
rough -ins) MECHANICAL APPLIANCES
UMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
VITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
Water Service meter size
Septic Tank - Not general)
Your sewer purveyor and t
Street use may require a "
Works Department.
Y UNDER THE PENALTY OF PE •
CT TO THE BEST OF MY KNOW
PREMISS TO PERFORM THE
LOW PREVENTERS, ET AL:
jl
___________
f known) Also see BOX 4
allowed in the City of Spokane Valley. For special circumstances contact
e Health District (See BOX 4)
• treet Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
JURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND •
EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ORK FOR WHICH THE AP.PLICATION IS MADE.
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard
Print the name of the Holder
Expiration Date
Signature
================ _______=___= OFFICE — _--___ _ ___—____—_—___--_—__________—__ —_ -----
Y=============================================
====___—= USE ONLY — PLEASE DO NOT WRITE BELOW_ ____________'____—__—_
____________________ __ THIS LINE
ZONE r_ SETBWCKS:' FRONT _______________________________________
SIDE
REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL ----
REMARKS DATE
DISAPPROVAL
SEPA:-EXEMPT --•: NOT EXEMPT
FIRE DEPARTMEN !? APPROVAL
� - DISAPPROVAL
DATE
REMARKS
l'I
PUBLIC WORKS DEARTMENT APPROVAL==============================================
________________________________________
• =========== —_—____________________________ DISAPPROVAL
DATE _-
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL ._._,IND. ADD/ALT
NEW COMMERCIAL • COMM. ALT/ADD
NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP.
ROOF OTHER
OCCUPANCY
•
BUILDING PERMIT NO.
PERMIT FEE
TYPE OF CONSTRUCTION
_BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
TOTAL SQ. FT.
PLAN CHECK FEE REC'D
PLAN CHECK FEE
TOTAL VALUATION
PLUMBING FEE
TOTAL FEES WSBCC SURCHARGE
OTHER CHARGES ; I
•
STORIES
RECEIPT NUMBER
ENERGY SURCHARGE
BUILDING DEPARTM,NT APPROVAL
. BY
MECH. FEE
AMOUNT DUE
DATE
ASSIGNED ADDRESS
CITY OF SPOKANE VALLEY
BUILDING DEPT.
PERMIT NUMBER
ADDRESS /j / A1
PLANS FC 6-0
OWNER C-')
DATE SUBMITTED / DATE APPROVED/`/0
APPROVED BY/ -u
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APPROVED BY
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