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2003, 04-14 Permit App: BD03-093 Finish Basement
City of SPOKANE VALLEY PERMIT # 613 q--2) BUILDING PERMIT APPLICATION �1cerL pLsr-i Box 1 OWNER Aypewr EnrecrmAses JOB LOCATION 31S va vV\..oiJ OWNER'S ADDRESS '214 INn.:mr�of d CITt.eewm.es PHONE 2%6-4102— DESCRIBE JOB -„.,i3.+ .fN ski -3 tivt-P' wi ts4gp wse THIS PROPERTY IS OWNED BY: SINGLARRIED PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME RAI baa Mes CONTRACTORS ADDRESS 3)-4 M..:t•ce.IJ PHONE 3rdi. - s3y CITY (Leenaeres, Wf- CONTRACTOR'S REG.# ‘-IAyoee—x en, IJArt EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT a_ etc. s PHONE 21L- %-r ADDRESS 3='4 CITY Ora races ZIP 990113 BOX 4 SEWER AVAILABILITY '/cS WATER AVAILABILITY des BOX 5 ESTIMATED PROJECT COST $ 7, 000 EXISTING BLDG. VALUATION $ 1 3.5-, boo BOX 6 PROPERTY TAX ACCOUNT NUMBER SS -1 °t2. ?',02 LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 3RD FLOOR / OTHER BASEMENT UNFINISHED rile / 1ST FLOOR /n$ / 2ND FLOOR / BASEMENT FINISHED / int DECK / GARAGE / CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING , y FT. ,BOX 8 (7). SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY SQ. FT. IMPERVIOUS SURFACE SQ. FT. BOX 9 PLUMBING FIXTURES (Including rough -ins) 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 P 0 W •R FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT DATE 4/1 q /03 (OVER) I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercard Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE Y ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL REMARKS DISAPPROVAL DATE SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS PUBLIC WORKS DEPARTMENT 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 TYPE OF CONSTRUCTION . STORIES BUILDING SQ. FT. BUILDING SQ. FT. BUILDING SQ. FT. BUILDING SQ. FT. TOTAL SQ. FT. @ 5`60 .11(09 7/. ©p TOTAL VALUATION BUILDING PERMIT NO. Ea CD3 --n LAN CHECK FEE RECD RECEIPT NUMBER PERMIT FEE /2'f . 2,4?EE) PLAN CHECK FEE 27. PLUMBING FEE n 00 MECH. FEE 1 7► COD TOTAL FEES WSBCC SURCHARGE l{,hD ENERGY SURCHARGE OTHER CHARGES BUILDING DEPARTMENT APPROVAL ASSIGNED ADDRESS 31,00 AMOUNT DUE H2O. Cop BY \1-- 1Cl Received DATE