2000, 06-22 Permit App: 00005230 Remodeltt
at AA
SPOIcANECOUIVY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260.
509-477-3675
Project Description: dapi%otiQNesid
TYPE OF APPLICATION
Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: 49/ lij flys! A,p,/
Assessor's Tax Parcel Number(s): i1
Legal Description:
ar:tment
Y
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
iinet Phone:
r 4 Fax:
Building height to peak
❑ Applicant.
Phone:
Fax.
4 dress-. A�� �/�/ /n
%//(/•/
Dimensions
Mailing Address.
2"d floor sq. ft.
Cittate , t
Occupancy group
City, State, Zip
Garage sq. ft.
0 C ntr or/j�n�/�%�/ �q� Phone
��y�y /I1yer
L lY/!A'!// . fr En l%�Zro Te9,S D
❑ Architect/Engineer
Phone
Fax
Mat ng addressLLa,,//
Mailing address
uy tart p
,� /.fib �912/4
/ City, State lip
C�
W tate Contractor lice ser
MON1eC14 055 r
Contact name:
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PROJECT INFORMATION
of
I:,,....`' =,:.• '....";, wilding Information-.
Building height to peak
N of stones
Hain floor sq. ft
Unfinished basement sq. ft.
Dimensions
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq ft
Cost of project��! �D t
Heat source (electric, gas, etc.)
Manufactured:Home .'...:
Sign.
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation =.;-,:-` : ° . :.
Fire Safety
Firm Name
Previous address
Fire Sprinkler
Tent
_
Paint booth Fire Alarm
Fireworks display
_
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Proposed use
Value
Address
Special In'spectioris,'Reguired?„ '
Non -Residential, Elierg ' f ode Compliance?
Firm Name
What is the current use of this property? J .
/'U�hlt ( //Y
Phone
Will the site be served by a septic system? 0 Yes 0 No
Pians 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)
(/ %) 0 Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
Address
Inspector
Phone
❑ Concrete
0 Welding
0 Bolting
0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? id Yes 0 No
If yes, identify on site plan
What is the current property size?
(square feet or acres) n
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan 0 Yes Ni.NptNo
What is the current use of this property? J .
/'U�hlt ( //Y
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 1011, 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 V. No
Are or will there be wells located on the property?
Ifyes,identifyonthe site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan 0 Yes It 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)
(/ %) 0 Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
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.Area?: - ;.,'.;::;.::'-:..s.:..,.,::...:..::_: ., ...,.:0.Yes:'.O NO.
Date Received.
Staff( Representative: