2004, 06-01 Permit App: BLD-04-04474 Garage91725
BUILDING PERMIT APPLICATION WORKSHEET
Sl®lone City of Spokane Valley Community Development Department
1TTT'"j Building Division
\Talley / O ` 11707 E. Sprague Avenue, Suite 206
_ „ Spokane Valley, WA 99206
�'/zb{•i • Phone: (509) 688-0036; Fax: (509) 688-0037
4/1-2
35-7- 4
REQUIRED SITE INFORMATION
Street Address:
S 9020 Wet ,nefr
/a/.
Assessor's Tax Parcel Number(s): 7
Legal Description:
Building Permit ❑ Change in Use C Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement n Fire Safety ❑ Other
PERMIT DESCRIPTION:
OWNER/APPLICANT INFORMATION
❑ Owner: 4424,7ocenl - rnvviniet
Phone: qaa-g3Sa Fax:
Address: .S qD-c rtgctinw /j(6 ,"
spy . taw.
State Zip Code
City
❑ Contractor: Se%/4/ze
Phone: 939-g3;O Fax:
Address: ,S y90 nim-vvo /e6.
S�o(z-- r�r/•F2 �j�i(fi
City State Zip Code
WA State Contractor License #:
❑ Applicant:
Phone:
Address:
Fax:
City
Architect:
Phone:
Address:
State Zip Code
Fax:
City
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:! 5i
DIMENSIONS: X 3 14
# OF STORIES: /
MAIN FLOOR TO SQ. FTG:
/O;0
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
/,//001 6i5
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
Al 1/) V ' 12
30% SLOPES ON PROPERTY:
es R ON-SITE SEPTIC
STEM?
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT.
Phone:
Inspector(s):
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to he pr•perty
Print Name git4 ri,nsv-r Signature ' / A -
er.
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check El Mastercard ❑ VISA ❑ Other
Bankcard #:
Authorized Signature:
Expires:
VIN#:
4
0
ADDRESS aAO 6 M A Po1 i' c
ZONE IAt3-7
ROAD WIDTH
FRONT
COMMENTS
REVIEWED
Thhs site plan is being subnened ter trio purple* ei
obtaining a building permit and is a true and coma
repn•sentahon of the proposal. Ah Masai warmly
IR 0. wmensions. curb lines, structures and essadr'3
Cave neen idenbbed. AISO gaWnd•
bodies of water.,gt s • • critical tea.
Sit;i ou•
nate:
4.6;9g9) 5)f7
, 7 /35a/.0
0
/DO.Ofr
ectim /24