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2001, 04-23 Permit App: 01002776 Skylights(,) _9_(>121,, I�I SpomNECOUNTY PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: / /// 7 ,L 77 toELL. Assessor's Tax Parcel Number(s): Legal Description: Project Description: /h e'faLer 2 -5/ /elk. 4LBuilding Permit O Change in Use O Grading O Manufactured Home Permit 0 Relocation O Sign O Tenant (New/Change) O Other e amn:se .'d.a...{;,?ps;;>AC�a;_a.e>r.,a_. :- Dh°-�+.• n. , ns yt.,.�se-^; :t� n-Watr.Diiri/Puiry"oi ' - _n-.- . . City. State, Zip b71s151 Ac ir£S CJ A— 990/(0 54weFDisicl_ureYo"' : _ -„O.S.�TjyC q, ::.;. r'"_'c..i,•-,tffv,»'�'y;. --_..a��� tAbackap;=. - aiwidli fi'-�•xi.'�::$"�,:''.. 1r'v h ."e c.F J^r C..e1J3{h 'School Dinncu .q:ai?.- sya: Lsr. '.;s'3: 1»,tb �~.• , T :r6 utik4r-+:-�`::1':i� ri i --an'.ai'::QsT`<},; .r".'.:=e2 ;Tit- ,:�. r.,,ec:-"'n_-'.:'�;-.`..i.�'a`�i=- � ki�:.a. ..e"Y6xe. �,.='--a��.'�.IS a_:M" t"'. .. " � s'.:r,, r' w:'.i �': a5s;.}�.� .°=:'�t`� �`r`.`.sp'9h+:v-:��t'3:; a._r3�;"�.i'L.riaai"..!�'i'L-s...a.....�a_,:'�'nre.vs�"{.�'.«�:�.:5�.:"::.hntc'�f+"�a�x;::..`airi�.<t`:.-,'"»rr.:`�:;'s t ""` ti.�.S$nI :.«_. �_- :i 1.o-. _ ,.Zoom £'::: _ �n :q -'- ��$•�-.d-�"Tn, 64"Jy`a�.s,�a'+S>`'ma' _ 't;:`'a',_.r t s -r•..-^ h�[,u _, _- -: __isnu_.>.' .;:.. .y., t '.<?-e. gl!_...e>�...`+x.;nM '.aT- ,--`a[s ::hy'Cft: ...�T'ia£Y elo 3'.'c.�tl I:eS._F yti �...:.r..s ,.” '�.:.:: t,<:,,�:.� r .3�:.:f . P.,.. = �'t ;n�w'���«_�. �,•�i::r �«.-.:L OWNER/APPLICANT INFORMATION /ndmate who should be contacted re ard,nv this Drotect 0 Owner: Phone: 9, 2 / 2 y F3A7/ £n s_ Dei.P Fax: 0 Applicant: Phone: Fax: Maling Address: /87/g C /nrvccorz Mailing Address Unfinished basement sq. ft. City. State, Zip b71s151 Ac ir£S CJ A— 990/(0 City, State, Zip 2"d floor sq. ft. / 0 Contactor (oat, Lilly) Phone 83d -(/.21/o (2,e'£gnaK4. 0//6i7// k s Faxc% 1677 O Architect/Engineer Phone Fax MailA address PO 43m/ol Mailing address Cost of prolettHeat �� / Sohl) Cir State Zip J5 "hitt i {J& Ifora,c, r City, State Zip WA State Contractor Iicense 1 � as /q T -n it /n / (CA - Contact name: PROTECT INFORMATION �v��x., ...rys�na`..yy... ..::':._ �:.)„o:;:""T•::",t ::u"-. .W=A�k�rcxR,.. _ _f9'.C,." .:'$ yti}'rr.. a:Biilldln'"'.Iu_forlilatlon',;. n g.. "r_. aq. :•r3 x�: ... J- a.., :. ,..:.o- .»,..c >..._:. '..: ;ir '..a:'•Y.. - ..us..r.,.. L --m.-, o. 'n,-a�.e7.ikL'.b� ... B«. ".� i'srF.':'r:a.::bs _.'i stt. ;:r,'" :i.�r:'^a'K a"i''g:•:;F:', :;`�<-i . :'b. ,r.; 3' - �J':' 'fi:i:yk�?.; i::rc:,tC.,�j;: . :>t�:ie5 ,..'.'.i ��. ,i , -.... ,, ...'•m:t4l:.... ,�- __.. _ -. ,�...., a�..�.._ ` Building height to peak 1 of stories Main floor sq. ft. Unfinished basement sq. ft. Dimensions Total habitable space 2"d floor sq. ft. Finished basement sq. h. Occupancy group Construction type Garage sq. ft. Deck sq. ft. Cost of prolettHeat �� / Sohl) source (electric, gas, etc) ManufacturedHome �d, Si n,, i,� ;z i t Width: Length: What is the square footage of the sign face? How high is the sign? Year: Make: N of signs Area of existing signs Are critical or hazardous materials used or stored on site? 0 Yes 0 No Address oeati n'E,§13:.4''.y ��...F�.r .x(`F '. Fr Relocatlon�� r• p::3--:�z:,. � .> '�rt�'- ::em=u : �<e3kPc £f ,.r � mh if.>...��!%: Pl a'' 'Yt:ve_.: x,. �;,....,��-� Fire Safe m �t`,�;'s�i:�. �::; ,�, �,... a i.. ��� ttr±•3. rd Previous address Fire Sprinkler Paint booth _ Fire Alarm Tent Fireworks display Phone Proposed use Value Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( -------%) O Yes 0 No yJ.M.F �, :eati e'r `Cn+�u' : Yf�'fyq.P ,za .. .. G .kv e W T '. "'c`y' Y.i�1+ ">ti y''R`.a i' F }rpeclaninspections Required'?. ,,,t J, eh.;-. ; ,Non '>`r4pf.. vcRY A':a:.. _ =: Ns:s :='X;"'i•,.'a F''iv'.F '4.P.J f,;r'.-''.aU't .:.:. .. t�` :L "ya :'�.. uKnw.. qp,�.m.. }.'% si ." c'`L'�a11w t}: u.`%s..tx,"-ace Aesldent al=Enet (5`deyCoimpliance? rrdt.`S?Pw'''�.+r Sis"3.;x`"".n`'*ti 'r--_%+'''7'»' :.:.r. �Ni i Firm Name What is the current use of this property? Phone Will the site be served by a septic system? 0 Yes 0 No Plans Examiner Phone Inspectors: Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( -------%) O Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes 0 No Address Inspector Phone 0 Concrete 0 Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Yes 0 No If yes, identify on site plan What is the current property size? (square feet or acres) Is any part of the property within 250 feet of a shoreline? If yes, identefy on sue plan 0 Yes 0 No What is the current use of this property? Is your property in a designated wildlife habitat area? 0 Don't know 0 Yes 0 No Will the site be served by a septic system? 0 Yes 0 No Is any part of the property within a 100 yr flood plain? If yes, identify on site plan 0 Maybe 0 Don't know 0 Yes 0 No Are or will there be wells located on the property? If yes, identify on the site plan 0 Yes 0 No Are there any wetlands, streams or ponds within 200 feet of the property? Ifyes, identify on site plan 0 Yes 0 No Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( -------%) O Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes 0 No DEPARTMENT USE ONLY dsrtlie.'property''iii;aid' "gnateedSionriwater Cdiftrob&ea?.s'; - ` '' 'wa?V3 ?•' x.�:C"-'`` .s'+' - i a. e-w(J::Yesy ' Os r_..xari - 3,...er..42.4"i+'.s.a.r. Iib .s-_'rs-xr--a. aH'P-Ziif.3'9. L6t. ~fi. cNO: i±" +'"sri�:.i-i F'J publtcsewerayailable rothesite>A -�"t Cr* ;Lcr iFlorKr%;,u. �?.x „�Z,", .H,.r r„y .x�'T _--�^t->„��.r 1,;,��.. - :& ,s _a -tiLI i c--47-Aar a:..T a-i,..�. Fc:F•�•_" �Is'the property;msidc tine'ASA? -5c 'r' ?CI Yes, O%Nt -:. K... 2�<!-'ay;��F�_e. ^-s'TNi .�tv-i ..4..'Xirs �...,. %t:r_a cY ._au?°y'a O. Ye_SMC `No: ....ak'a'. w - r Ulf Is.pubhc;warer avatl`alile;m the*site?: ? 4 ' ^t`O=tYesti `O 1Vo t ?Sy l:..t nF3=..<L»..'/.:...��C'a:..,i�^Sl'h n x!.. Y�gs�,s- `h'.. ValCs� at �_ . Y. er-:era sur��:.�J, .ida$a.'�3. rls[lie ro' a 'iiisidai e`�PSSA. 'O' Yes• O;r1o" - '' 1."''�*(= ..;,„:,; c._.. mss., . P P .&13. t: -vhr'r;: F==xr<: >;-.,�t? �riL;. "gr:. t=?:J:.;:k*„ "r:R+,..''";,#":_i, J.�.frs,.�fis ,..,.;.v,-._,.... .z:r.;�:a...._�..:.,+.x,.t..��,..._�::v.,er:_a.�s_;'�.::e�:_�s:.,r�,'.,`��'tix'.4.:.©�Yeetf7'iNo.r_,: * o tr. ` £ �°"' Isiihedpioperrylocated�wiyi7uuy1000}feet.of;a;Naturaltlteso'u`rce°Aiea?x'"; r. _..thu .',„..C1 -- - ",s`,W �;�t.y`•„r;:is? .sa ,4.:s �g Date Received. Staff Representative: METHOD OF PAYMENT vrsa ❑ CASH ❑ CHECK ❑Una❑ !.._`v'_..I ia`: ❑ FAXED PERMITS WILL ONLY BE ACEI'TED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: DIMMER BANFCARD NUMBER: AUTTIORIZED SIGNATURE: SUBTOTAL :K 4.,-,.- ' 3 ::.r..' ._•u.-�s='>".�C¢.r.�-'�i�TOTti FEES 1NLN,fIM PERAIR'F_t'E1S dJl.ovP1EASE `. "bMAAECHEGI_(SPAYABLL.'lpSPORAIVE=- ';--1 COUIv1YPMiclin'CEMFfti.;'^'': t- "r= R f ,-,r.s� w Pr'=4�,;1