2003, 05-19 Permit App: BD-03-484 DeckCity of
SPOKANE VALLEY
&90- 003 (0
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PERMIT # B p 03 - Lica i
BUILDING PERMIT APPLICATION
Boxi OWNPR Gam- - James ,1 A i OB LOCATION J N20 F. Man bmP
OWNER'S ADDRESS CITY :•HONE 9dlo`,/e 9
DESCRIBE JOB /V?� fl c ,C _ /
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED _V&Ii/r°
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME ryl PHONE
CONTRACTOR'S ADDRESS CITY
CONTRACTOR'S REG.#
EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VE F IFIED)
BOX 3 CONTACT PERSON OF PROJECT jPHONE
ADDRESS CITY ZIP
BOX4SEWER AVAILABILITY � WATER AVAILABILITY (s. -J /M.e,a/��4e,�?�
BOX 5 ESTIMATED PROJECT COST $ _, (522- EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) zr t (lo t )
CENSUS NUMBER LOT NUMBER V `�
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR
3RD FLOOR / OTHER
/ 2ND FLQOR
FINISHED /
BASEMENT UNFINISHED / DECK Ali
/ -AGE /
CARPORT / TOTAL / • IGHT TO PEAK OF BUILDING • FT.
BOX 8 "%il SINGLE FAMILY ( ) NEW CONSTRUCTION
MULTIFAMILY (NO. OF UNITS ) • ( ) EXISTING STRUCTURE
( )' COMMERCIAL / INDUSTRIAL TCTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE { SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICA;_ FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSEF.TS, WATER HEATERS, CONVERSI5N BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. IP
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 sever, water, sidewalks, curb cuts. Contact the Public
Works Department
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
;ORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO RFpRM THE WORK FOR WHICH THE APPLICATION IS MADE.
3WNER! AGENT �'�✓
MAY 16 2003 13:46
DATE 5l%743 (OVER)
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FINAL AS-BU1L'i INSTALLATION
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THE LOCATION OF THE ON-SITE SEW ♦ 1.1 1
SYSTEM REPRESENTED BY THE DRAW �` 1
IS NOT TO BE CONSTRUED AS AN
EXACT LOCATION Of THE SYSTEM.
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NOR1H
MAY 16 2003 13:48
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