2003, 10-22 Permit App: BLD-03-02863 Finish Basement1
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
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STREET ADDRESS: 307 S MQQ20W L/.)
ASSESSOR'S TAX PARCEL NUMBER(S): �!^^ t'�5 a Aa , - Co'C)a
LEGALDISCRIPTION: L O S I u(- r��+AL PLAT ac- KEIS74Yae ME&Boi-JS PE I8?(0O-gic Jo t_ ZLc f 3
PERMIT DESCRIPTION: 10 FNISEI q Poe-(loki or ISPS6MFnJT
�BUILDING PERMIT ° CHANGE IN USE ° GRADING
°RELOCATION • Q -SIGN °TENANT
° MANUFACTURED HOME
El -OTHER
OWNER / APPLICANT INFORMATION
OWNER: 441W gXbM Oita"
7q,!R uro
4,000 717rf As
PHONE: (5z) i -0)-1I3 FAX:
307 S, moan., LAi
ADDRESS:
Fir
CONTRACTOR:
N(ic•rEutd)4,-150-1 /,/I
APPLICANT: 4 43 uj
PHONE: ( f)aq) x413
S1tYOSJE JA`s Uk ADDRESS: 307 S, MJ22U'-, 14 Seo
ego Autnj
CITY, STATE, ZIP
® ARCHITECT:
FAX:
CITY,STATE, ZIP
PHONE: 5/Vit 6 -
FAX:
ADDRESS:
CITY, STATE, ZIP
WA STCONTRACTOR LICENSE 11
f.�
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 7CYX) r. ?LU)
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
MAIN FLOOR SQ FT:
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
STRUCTURES ON PROPERTY: - FINISHED BASEMENT:
GARAGE:
CURRENT PROPERTY SIZE: COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE:
CRITICAL AREAS:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN; HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION
FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER:
PAINT BOOTH:
FIREWORKS DISPLAY:
FIRE ALARM:
TENT:
BLASTING: DATE/TIME:
I WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
•
ADDRESS: '
I
CITY, STATE, ZIP
SPECIAL INSPECTIONS
CI BOLTING
FIRM NAME:
INSPECTOR(S):
®CONCRETE
CI REINFORCEMENT
PHONE:
® WELDING
FAX:
BUILDING STAFF USE ONLY
1
IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: 0 COUNTY 0 CITY
IS PUBLIC WATER AVAILABLE: 0
YES ® NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO
PSSA: 0 YES 0 NO
DATE:
1
STAFF:
1
METHOD OF PAYMENT:
® 0
CASH CHECK
VISA
BANKCARD #,• EXP/RES: VIN #
AUTHOR/ZED SIGNATURE:
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
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