2003, 04-22 Permit App: BD03-142 MHCity of
SPOKANE VALLEY
PERMIT # (2)Do
BUILDING PERMIT APPLICATION
Box 1 OWNER 44r1 V,c,.)
OWNER'S ADDRESS MisegrA CITY
JOB LOCATION /WY ElocrLii✓
PHONE
DESCRIBE JOB ro../81-4 // MAniu calt-c v'e-cI ?-fie rc1 e
THIS PROPERTY IS OWNED BY
PARTNERSHIP CORP.
not. Int •10 La IS f
ARRIED
Dr,
BOX 2 CONTRACTOR'S NAME /1/1,G%u v ,) PHONE ao? (o 311/4P
CONTRACTOR'S ADDRESS •a go/.S— l?!Ver- Re/
CITY (/Trs Dge 4ArJS
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT &trt Qr2VE4 PHONE 22? a/o '607
ADDRESS S.A.25 Pru -rev, Rd CITY Deer P vie
ZIP % 9 0o.
BOX 4 SEWER AVAILABILITY Sege fi
WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ '-/000
EXISTING BLDG. VALUATION $ /01000
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DE$$CRIPTION / /_
4-3 B LK to BAr/(er Rd Mo of fe /r -o � e,9
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR 1 OTHER
BASEMENT UNFINISHED /
CARPORT / TOTAL
1ST FLOOR /191/2 2ND FLOOR /
/ BASEMENT FINISHED /
DECK / GARAGE /
• /
HEIGHT TO PEAK OF BUILDING
/ 3 FT.
BOX 8 ()() 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 PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT
DATE /i? aid, 3 (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
OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE
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. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS
'�ICTI'uF��/'
,ppne 11707 E. SPRAGUE, STE 106
Val ley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
PROJECT TRANSMITTAL:
TRANSMITTAL DATE: L f -E -o
SITE INFORMATION PERMIT INFORMATION
Site Address: /14, E M a r I i ✓\ oC
Spokane , k) A- 99027
Parcel Number: 56-D a-/�Q(p 03
Subdivision:Earice/ R Q mobil P No1Mtcs
Block: u Lot: 3
Zoning: (A(2_7 Water Dist:
Owner: OA f I GigrU-t✓t
Address: 6 vn .€
Building Inspector: ,
Permit Number: BOO 3-l'Z- Issue Date: nn
Permit Use:I?, eplae€ Doudol•P W tc9 C
Kt. aU'Io")CSCo'z"
Applicant: ou3Y Q%
Phone: _
Contact: CC< r l C`7 i rU e./r,
Phone(G12ij 710 - VDQ 7
Contractor:
Setbacks — Front: Y Left: S Right:5— Rear: 5�
APPROVALS ��
(RO C,C I-11-7/ /t 4-02)-03
• BUILDD S:
PLANN
cts
HEALTH:X� r9 . fi p Q r » /c eiYm RJ.
van or 404-7 Nos*.
riliane 11707 E. SPRAGUE, STE 106
`Valley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMTI7AL:
TRANSMITTAL DATE: 5 -aa _o
PERMIT INFORMATION
Site Address: ?/t4 E Marlin
S(x�Vr�nt ,wry- 99027
or
Parcel Number: ,`j"SD�2-O(o 03
Subdivision:Ecv-Kei R,cP thitobLle hicvhe
Block: Lk
Zoning: (AR -7
Owner: CG r I C7 ; r u 'P-rf
Address: Sot, tin €
Lot: 3
Water Dist:
Building Inspector: T3 r i4
Permit Number: apo3-/4 Z Issue Date:
Permit Use:1cpI0.etDou.b', wicQe-
/
Applicant: Ory) or
Phone:
Contact: Qr! Cc rlCn-,
Phone(c?2io-?fro 7
Contractor:
Setbacks —Front:? Left: S Right:S Rear:
BUILD
l D
APPROVALS
fJ_
k 100 - konro 2 COurt-
/; 4 -2-03
HEALTH: S
r14- t t i nl 7) �
1
_Chat
32'
APPROVED Rv >Ea