Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2005, 05-04 Permit App: 05001426 Tear Off, Reroof
S�ktfle .000Ua11ey BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: 1 (Q1 q S _ O✓✓"C LJ 65 Assessor's Tax Parcel Number(s): Legal Description: n PERMIT DESCRIPTION: Teta,— OA( t' — oT E Building Permit ❑ Relocation ❑ Change in Use ❑ Grading 0 Manufactured Home ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION Owner. L Leo 4,,JA.,,,. Phone: 00J -I -1063 Fax: Address: 11, I °t S - MB,i,2„1 €-„De2ic0we 14,4- r a-ofo Crtyff State Zip Code City State Zip Code Er -Contractor: Pen VL L` .y 0 Architect: Phone: 9J4 -373i Fax: €2,14- -mei< Phone: Fax: Address: hp 10-1; .1-1 it G3 Address: S D6 C+`01.1/4S--- wA- `1Cra I lq citli ❑ - Applicant: Qs C��/VD C v Phone: Fax: Address: State Zip Code City State Zip Code WA State Contractor License #: pl4 k r_cmg 5 Contact: (w -e --o 6 "cJcj CP Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: # OF STORIES: MAIN FLOOR TO SQ. FTG: 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT:S�� 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? / MANUFACTURED HOME. Width: Manufacturer: Length: Year: ---- Pit Set: r RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Inspector: Address: Phone: Fax: City Phone: State Fax: Zip City State Zip SPECIAL INSPECTIONS ❑ BOLTING ❑ CONCRETE Firm Name: ❑ REINFORCEMENT Phone: Inspector(s): Fax: ❑ WELDING DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the properly owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center.5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state .r local laws, codes bordir?ances. Ownership of resulting development rights granted by any issued p; it inure to the pro Print Name Lcvvevo C ✓'IOL te Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) Mastercard ❑ VISA ❑ Other Bankcard #: S`i 1 "35y /?k�{ 4kd I V Expires: /I/©'7 VIN#: 5 Is? ❑ Cash ❑ Check Authorized Signature: L\N; \ .