2007, 05-21 Permit App: 07001859 MHProject Number: 07001859 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/21/2007 Page 1 of 2
Project Information:
Permit Use: DOUBLE WIDE MANU HOME REPLACEMENT Contact: CLAYTON HOMES
Address: 15906 E SPRAGUE AVE
C - S - Z: SPOKANE VALLEY, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 891-9996
Group Name:
Site Information: Project Name:
Plat Key: 002378 Name: SIESTA MOBILE PARK ADD
District: F
Parcel Number: 45203.0133 Block: 1
SiteAddress: 908 S NINA CIR
Location:: CSV
Zoning: UR -7
Water District:
Urban Residential -7
Area: ',500.00 Acres
Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot: 5
Owner: Name: HAYES, WAYNE
Address: 908 S NINA CIRCLE
SPOKANE VALLEY, WA 99206
Hold: !_]
Depth: 0 Right Of Way (ft): 0
Review
Flood Plain
Released By:
SEE CONDITION
Building Plan Review
Originally Released: 05/03/2007 By: MSUKUP
Released By:
Originally Released: 05/18/2007 By: TMELBOU
Landuse/Zoning/HE Conditions
Released By:
PER APPROVED SITE PLAN
Originally Released: 05/18/2007 By: TSCHMIDT
Operator: MT Printed By: MT Print Date: 05/21/2007
Project Number: 07001859 Inv: 1
Application
Date: 05/21/2007 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Sewer Review
Permits:
Released By:
05003496
Originally Released: 05/18/2007 By: mturbak
Contractor: OWNER
Contractor: OWNER
Item Description
INSPECTION FEE
Notes:
Payment Summary:
Permit Type
Manufactured Home
Flood Plain
Firm: OWNER
Phone: (000) 000-0000
Manufactured Home
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 # SECTIONS
Permit Total Fees:
Fee Amount
$100.00
$100.00
Fee Amount Invoice Amount Amount Paid Amount Owing
$100.00 $100.00
$0.00 $100.00
$100.00 $100.00 $0.00 $100.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: MT Printed By: MT Print Date: 05/21/2007
AiB S n`; 'L, L r ,
5 ; 4D
mow, r
wAilD
rA
DATE:
� c'
x25-'
ibe
CITt0kne
., . Malley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 F(5¢99637
www.spokanevalley.org
Manufactured Home
Permit Application
OTHER
PERMIT NUMBER: O 1- 1
561
PERMIT FEE:
SITE ADDRESS: 90 S6.1 w
ASSESSORS PARCEL NO:
C,r. Beak-..". Vt.1tt7 �.)e� 0.442E
LEGAL DESCRIPTION:
Building Owner:
Length:
, . Z: �„
Name: L.i on r.� M‘ t S
-Lou 0(..
IA44
Address:
er,:„)
City:
State:
to 14A-4 '114. i I L
V4
Zip: qk 1_0
Phone:
I
$I Z ..3 0 `M r( s- i Fax:
Contractor Lic No:
Exp Date:
Contact Person
Name: roc . F r c..h-s
Phone: V- Toa- b ®
Describe the scope of work in detail:
Contractor:
Length:
, . Z: �„
Name:
WV, e.het
-Lou 0(..
IA44
Address:
er,:„)
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
t`I
mCA" v f..A OwkAi
S; 4.") r(.rpl.,tt,s
MANUFACTURED HOME
Width:.1 oy
Length:
, . Z: �„
Year: ZtS0(4
Pit Set:
IA44
Septic/
er,:„)
# Manufacture:5 'CIk
Previous Address:
Proposed Use:
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 property 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 or
local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
Signature '/•
Method of Payment:
0 Cash
Bankcard #:
0 Check
Date L//ji /G7
❑ Mastercard ❑ VISA
Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005 i 11 i Z t/LC, -1
% r
41fitE-R- ACKC,
rz)446
5098919360 CLAYTON HOMES
6
3
#F
OTE
1.IT IS CONTRACTOR
RESPONSABILITY TO PROVIDE
VENTILATION (1FT. SQR. VENT
PER. 100 FT. SQR. FLR. AREA
MIN. WITHIN 12"
TOP--OF--SLAB)
2. LAP SPLICE ALL CONT.
REINF. 24" MIN.
#4 VERT. ® 48" O.C.
IN SIMPSON (SET)
EPDXY ADHESSIVE,
EMBED = 2-)'" MIN.
4"
04:47--40 p_m_
2x6 CONT_ BASE PLATE
(TREATED) W/ )z"0 x REQ'D
LENGTH ANCHOR BOLT 0 48"
O.C. EMBED_=7"
05-11-2007 2 /2
#4 CONT.
8" CMU
EXTERIOR
WALL
SLOPE=5%
EXIST. 6" CONC.
SLAB -ON -GRADE
TYPICAL PERIMITER WALL SECTION
EXPIRES 09/23/7J
N. T.S.
a TPROJECT
CANING
WAYNE HAYES
DATE
5-11-07
SHT.NO.
1
1
D1
STRUCTURAL CONSULTING
J.N. 4407, SPOKANE VALLEY
BY
CAN
To:
CLAYTON HOMES
eg-c1M-Thrz..-
-NCD ESQ
Zee Build L z7ind "
04:47:28 p.m.
05-11-2007 1 /2
CLAYTON HOMES, INC. WI 3
15906 E Sprague Avenue
Spokane valley, WA 99037
Office (509) 891-9996
Fax (509) 891-9360
Emu,i 1 rlo93 @ Clayton. net
FAX
Fax:
Phone: V
Ci 141.41,0( a(rce
Re:
Comments:
From:
Pages:
Date:
cc:
• • • CONFIDENTIALITY NOTICE " •
The information contained in this fax message is privileged and confidential information intended only for the use of the
individual or entity named above. If the reader of this message is not the intended recipient or the employee or agent
responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution, or copying
of this communication is strictly prohibited.
If you have received this communication in error, please notify us immediately by telephone and return the original
message to us at the above address via U.S. Postal Service.
Pei. `)4/05 CMH 1299
[F] SECTION R321
SITE ADDRESS
R321.1 Premises identification. Approv d numbers or ad-
dresses shall be provided for all new build ngs in such a posi-
tion as to be plainly visible and legible fro the street or road
fronting the property.
[B] SECTION R322
ACCESSIBILITY
R322.1 Scope. Where there are four or more dwelling units or
sleeping units in a single structure, the provisions of Chapter 11
of the International Building Code for Group R-3 shall apply.
SECTION R323
FLOOD -RESISTANT CONST
R323.1 General. Buildings and structures
hazard areas (including A or V Zones) as
R301.2 (1) shall be designed and constn
with the provisions contained in this secti
SUCTION
onstructed in flood
stablished in Table
cted in accordance
n.
Exception: All buildings and strucitures in identified
floodways as established in Table R301.2 (1) shall be de-
signed and constructed as stipulated ii the International
Building Code.
R323.1.1 Structural systems. All structural systems of all
buildings and structures shall be designed, connected and
anchored to resist flotation, collapse or permanent lateral
movement due to structural loads and stresses from flooding
equal to the design flood elevation.
R323.1.2 Flood -resistant construction. All buildings and
structures erected in areas prone to flooding shall be con-
structed by methods and practices that minimize flood dam-
age.
R323.1.3 Establishing the design flood elevation. The de-
sign flood elevation shall be used to d fine areas prone to
flooding, and shall describe, at a mini um, the base flood
elevation at the depth of peak elevation of flooding (includ-
ing wave height) which has a 1 percent (100 -year flood) or
greater chance of being equaled or ex eeded in any given
year.
R323.1.4 Lowest floor. The lowest floo shall be the floor of
the lowest enclosed area, including bas ment, but excluding
any unfinished flood -resistant enclos re that is useable
solely for vehicle parking, building access or limited storage
provided that such enclosure is not built so as to render the
building or structure in violation of this section.
R323.1.5 Protection of mechanical and electrical sys-
tems. Electrical systems, equipment d components, and
heating, ventilating, air conditioning d plumbing appli-
ances, plumbing fixtures, duct system , and other service
equipment shall be located at or abovea design flood ele-
vation. If replaced as part of a substantial improvement,
electrical systems, equipment and components, and heating,
ventilating, air conditioning, and plumbing appliances,
plumbing fixtures, duct systems, andther service equip-
ment shall meet the requirements of this section. Systems,
BUILDING PLANNING
fixtures, and equipment and components shall not be
mounted on or penetrate through walls intended to break
away under flood loads.
Exception: Electrical systems, equipment and compo-
nents, and heating, ventilating, air conditioning and
plumbing appliances, plumbing fixtures, duct systems,
and other service equipment are permitted to be located
below the design flood elevation provided that they are
designed and installed to prevent water from entering or
accumulating within the components and to resist hydro-
static and hydrodynamic loads and stresses, including
the effects of buoyancy, during the occurrence of flood-
ing to the design flood elevation in compliance with the
flood -resistant construction requirements of the Interna-
tional Building Code. Electrical wiring systems are per-
mitted to be located below the design flood elevation
provided they conform to the provisions of the electrical
part of this code for wet locations.
R323.1.6 Protection of water supply and sanitary sew-
age systems. New and replacement water supply systems
shall be designed to minimize or eliminate infiltration of
flood waters into the systems in accordance with the plumb-
ing provisions of this code. New and replacement sanitary
sewage systems shall be designed to minimize or eliminate
infiltration of floodwaters into systems and discharges from
systems into floodwaters in accordance with the plumbing
provisions of this code and Chapter 3 of the International
Private Sewage Disposal Code.
R323.1.7 Flood -resistant materials. Building materials
used below the design flood elevation shall comply with the
following:
1. All wood, including floor sheathing, shall be pressure
preservatively treated in accordance with AWPA Cl,
C2, C3, C4, C9, C15, C18, C22, C23, C24, C28, P1,
P2 and P3 or decay -resistant heartwood or redwood,
black locust, or cedars.
2. Materials and installation methods used for flooring
and interior and exterior walls and wall coverings
shall conform to the provisions of FEMAJFIA-TB-2.
R323.1.8 Manufactured housing. New or replacement
manufactured housing shall be elevated in accordance with
Section R323.2 and the anchor and tie -down requirements
of Sections AE604 and AE605 of Appendix E shall apply.
The foundation and anchorage of manufactured housing to
be located in identified flood ways as established in Table
R301.2(1) shall be designed and constructed in accordance
with the applicable provisions in the International Building
Code.
R323.1.9 As -built elevation documentation. A registered
design professional shall prepare and seal documentation of
the elevations specified in Section R323.2 or R323.3.
R323.2 Flood hazard areas (including A Zones). All areas
that have been determined to be prone to flooding but not sub-
ject to high velocity wave action shall be designated as flood
hazard areas. All buildings and structures erected in flood haz-
ard areas shall be designed and constructed in accordance with
Sections R323.2.1 through R323.2.3.
2003 INTERNATIONAL RESIDENTIAL CODE® 57
APPENDIX G
hibited by this section where specific enforcement would result
in unnecessary hardship.
VIOLATION. A development that is not fully compliant with
this appendix or Section 1612, as applicable.
SECTION G301
SUBDIVISIONS
G301.1 General. Any subdivision proposal, including propos-
als for manufactured home parks and subdivisions, or other
proposed new development in a flood hazard area shall be
reviewed to assure that:
1. All such proposals are consistent with the need to mini-
mize flood damage;
2. All public utilities and facilities, such as sewer, gas, elec-
tric and water systems are located and constructed to
minimize or eliminate flood damage; and
3. Adequate drainage is provided to reduce exposure to
flood hazards.
G301.2 Subdivision requirements. The following require-
ments shall apply in the case of any proposed subdivision,
including proposals for manufactured home parks and subdivi-
sions, any portion of which lies within a flood hazard area:
1. The flood hazard area, including floodways and areas
subject to high velocity wave action, as appropriate, shall
be delineated on tentative and final subdivision plats;
2. Design flood elevations shall be shown on tentative and
final subdivision plats;
3. Residential building lots shall be provided with adequate
buildable area outside the floodway; and
4. The design criteria for utilities and facilities set forth in
this appendix and appropriate International Codes shall
be met.
SECTION G401
SITE IMPROVEMENT
G401.1 Development in floodways. Development or land dis-
turbing activity shall not be authorized in the floodway unless it
has been demonstrated through hydrologic and hydraulic anal-
yses performed in accordance with standard Engineering prac-
tice that the proposed encroachment will not result in any
increase in the level of the base flood.
G401.2 Flood hazard areas subject to high velocity wave
action.
1. Development or land disturbing activity shall only be au-
thorized landward of the reach of mean high tide.
2. The use of fill for structural support of buildings is pro-
hibited.
G401.3 Sewer facilities. All new or replaced sanitary sewer
facilities, private sewage treatment plants (including all pump-
ing stations and collector systems) and on-site waste disposal
systems shall be designed in accordance with Chapter 8, ASCE
24, to minimize or eliminate infiltration of fl9odwaters into the
facilities and discharge from the facilities into floodwaters, or
impairment of the facilities and systems.
G401.4 Water facilities. All new replacement water facilities
shall be designed in accordance with the provisions of Chapter
8, ASCE 24, to minimize or eliminate infiltration of flood-
waters into the systems.
G401.5 Storm drainage. Storm drainage shall be designed to
convey the flow of surface waters to minimize or eliminate
damage to persons or property.
G401.6 Streets and sidewalks. Streets and sidewalks shall be
designed to minimize potential for increasing or aggravating
flood levels.
SECTION G501
MANUFACTURED HOMES
G501.1 Elevation. All new and replacement manufactured
homes to be placed or substantially improved in a flood hazard
area shall be elevated such that the lowest floor of the manufac-
tured home is elevated to or above the design flood elevation.
G501.2 Foundations. All new and replacement manufactured
homes, including substantial improvement of existing manu-
factured homes, shall be placed on a permanent, reinforced
foundation that is designed in accordance with Section 1612.
G501.3 Anchoring. All new and replacement manufactured
homes to be placed or substantially improved in a flood hazard
area shall be installed using methods and practices which mini-
mize flood damage. Manufactured homes shall be securely
anchored to an adequately anchored foundation system to resist
flotation, collapse and lateral movement. Methods of anchor-
ing are authorized to include, but are not limited to, use of
over -the -top or frame ties to ground anchors. This requirement
is in addition to applicable state and local anchoring require-
ments for resisting wind forces.
SECTION G601
RECREATIONAL VEHICLES
G601.1 Placement prohibited. The placement of recreational
vehicles shall not be authorized in flood hazard areas subject to
high velocity wave action and in floodways.
G601.2 Temporary placement. Recreational vehicles in flood
hazard areas shall be fully licensed and ready for highway use,
and shall be placed on a site for less than 180 consecutive days.
G601.3 Permanent placement. Recreational vehicles that are
not fully licensed and ready for highway use, or that are to be
placed on a site for more than 180 consecutive days, shall meet
the requirements of Section G501 for manufactured homes.
SECTION 701
TANKS
G701.1 Underground tanks. Underground tanks in flood haz-
ard areas shall be anchored to prevent flotation, collapse or lat-
eral movement resulting from hydrostatic loads, including the
effects of buoyancy, during conditions of the design flood.
Above -ground tanks. Above -ground tanks in flood hazard
areas shall be elevated to or above the design flood elevation
or shall be anchored or otherwise designed and constructed
to prevent flotation, collapse or lateral movement resulting
from hydrodynamic and hydrostatic loads, including the ef-
fects of buoyancy, during conditions of the design flood.
6i8 2003 INTERNATIONAL BUILDING CODE®
STRUCTURAL DESIGN
TABLE -1610.1
OIL LATERAL LOAD
DESCRIPTION OF BACKFILL MATERIAL
UNIFIED SOIL
CLASSIFICATION
DESIGN LATERAL SOIL LOADa
(pound per square foot per foot of depth)
Active pressure
At -rest pressure
Well clean -sand mixes
GW
30
60
-graded, gravels; gravel
Poorly clean gravel -sand mixes
GP
30
60
graded gravels;
Silty graded gravel -sand mixes
GM
40
60
gravels, poorly
Clayey graded gravel -and -clay mixes
GC
45
60
gravels, poorly
Well -graded, clean sands; gravelly sand mixes
SW
30
60
Poorly clean sands; sand -gravel mixes
SP
30
60
graded
Silty sands, graded sand -silt mixes
SM
45
60
poorly
Sand -silt clay mix with plastic fines
SM -SC
45
100
Clayey sands, graded sand -clay mixes
SC
60
100
poorly
Inorganic silts and clayey silts
ML
45
100
Mixture of inorganic silt and clay
ML -CL
60
100
Inorganic clays of low to medium plasticity
CL
60
100
Organic silts and silt clays, low plasticity
OL
Note b
Note b
Inorganic clayey silts, elastic silts
MH
Note b
Note b
Inorganic clays of high plasticity
CH
Note b
Note b
Organic clays and silty clays
OH
Note b
Note b
For SI: 1 pound per square foot per foot of depth = 0.157 kPa/m, 1 foot = 304.8 mm.
a. Design lateral soil loads are given for moist conditions for the specified soils at their optimum densities. Actual field conditions shall govern. Submerged or satu-
rated soil pressures shall include the weight of the buoyant soil plus the hydrostatic loads.
b. Unsuitable as backfill material.
c. The definition and classification of soil materials shall be in accordance with ASTM D 2487.
1611.2 Ponding instability. Ponding refers to the retention of
water due solely to the deflection of relatively flat roofs. Roofs
with a slope less than one-fourth unit vertical in 12 units hori-
zontal (2 -percent slope) shall be investigated by structural anal-
ysis to ensure that they possess adequate stiffness to preclude
progressive deflection (i.e., instability) as rain falls on them or
meltwater is created from snow on them. The larger of snow
load or rain load shall be used in this analysis. The primary
drainage system within an area subjected to ponding shall be
considered to be blocked in this analysis.
1611.3 Controlled drainage. Roofs equipped with hardware
to control the rate of drainage shall be equipped with a second-
ary drainage system at a higher elevation that limits accumula-
tion of water on the roof above that elevation. Such roofs shall
be designed to sustain the load of rainwater that will accumu-
late on them to the elevation of the secondary drainage system
plus the uniform load caused by water that rises above the inlet
of the secondary drainage system at its design flow determined
from Section 1611.1. Such roofs shall also be checked for
ponding instability in accordance with Section 1611.2.
SECTION 1612
FLOOD LOADS
1612.1 General. Within flood hazard areas as established in
Section 1612.3, all new construction of buildings, structures
and portions of buildings and structures, including substantial
2003 INTERNATIONAL BUILDING CODE®
improvements and restoration of substantial damage to build-
ings and structures, shall be designed and constructed to resist
the effects of flood hazards and flood loads.
1612.2 Definitions. The following words and terms shall, for
the purposes of this section, have the meanings shown herein.
BASE FLOOD. The flood having a 1 -percent chance of being
equaled or exceeded in any given year.
BASE FLOOD ELEVATION. The elevation of the base
flood, including wave height, relative to the National Geodetic
Vertical Datum (NGVD), North American Vertical Datum
(NAVD) or other datum specified on the Flood Insurance Rate
Map (FIRM).
BASEMENT. The portion of a building having its floor
subgrade (below ground level) on all sides.
DESIGN FLOOD. The flood associated with the greater of the
following two areas:
1. Area with a flood plain subject to a 1 -percent or greater
chance of flooding in any year; or
2. Area designated as a flood hazard area on a community's
flood hazard map, or otherwise legally designated.
DESIGN FLOOD ELEVATION. The elevation of the
"design flood," including wave height, relative to the datum
specified on the community's legally designated flood hazard
map. In areas designated as Zone AO, the design flood eleva-
tion shall be the elevation of the highest existing grade of the
299
1
STRUCTURAL DESIGN
building's perimeter plus the depth numbe
on the flood hazard map. In areas designated
a depth number is not specified on the map
shall be taken as being equal to 2 feet (610
DRY FLOODPROOFING. A combinatio
cations that results in a building or struct
attendant utility and sanitary facilities, bei
walls substantially impermeable to the pas
with structural components having the cap.
as identified in ASCE 7.
EXISTING CONSTRUCTION. Any bu
tures for which the "start of construction"
the effective date of the community's first fl
ment code, ordinance or standard. "Existi
also referred to as "existing structures."
EXISTING STRUCTURE. See "Existing
FLOOD or FLOODING. A general and to
of partial or complete inundation of normal
1. The overflow of inland or tidal water
2. The unusual and rapid accumulation
waters from any source.
FLOOD DAMAGE -RESISTANT MATE
struction material capable of withstandin
longed contact with floodwaters witho
damage that requires more than cosmetic re
•
(in feet) specified
as Zone AO where
the depth number
).
of design modifi-
re, including the
g water tight with
sage of water and
city to resist loads
ldings and struc-
ommenced before
od plain manage -
g construction" is
construction"
porary condition
y dry land from:
runoff of surface
LS. Any con -
direct and pro -
t sustaining any
air.
FLOOD HAZARD AREA. The greater of the following two
areas:
1. The area within a flood plain subject to a 1 -percent or
greater chance of flooding in any ye.
2. The area designated as a flood hazard
nity's flood hazard map, or otherwise 1: gaily designated.
FLOOD HAZARD AREA SUBJECT TO HIGH VELOC-
ITY WAVE ACTION. Area within the flood hazard area that
is subject to high velocity wave action, and shown on a Flood
Insurance Rate Map (FIRM) or other flood hazard map as Zone
V, VO, VE or V1-30.
FLOOD INSURANCE RATE MAP (FIRM). An official
map of a community on which the Federal Emergency Man-
agement Agency (FEMA) has delineated both the special flood
hazard areas and the risk premium zones applicable to the com-
munity.
FLOOD INSURANCE STUDY. The offici
by the Federal Emergency Management Agei
Flood Insurance Rate Map (FIRM), the Flo
Floodway Map (FBFM), the water surface eh
flood and supporting technical data.
FLOODWAY. The channel of the river, creek or other water-
course and the adjacent land areas that must be reserved in
order to discharge the base flood without cu ulatively increas-
ing the water surface elevation more than a de ignated height.
LOWEST FLOOR. The floor of the low st enclosed area,
including basement, but excluding any unfinished or
flood -resistant enclosure, usable solely for vehicle parking,
building access or limited storage provided that such enclosure
ea on a commu-
i1 report provided
icy containing the
�d Boundary and
vation of the base
300
is not built so as to render the structure in violation of this sec-
tion.
SPECIAL FLOOD HAZARD AREA. The land area subject
to flood hazards and shown on a Flood Insurance Rate Map or
other flood hazard map as Zone A, AE, A1-30, A99, AR, AO,
AH, V, VO, VE or V1-30.
START OF CONSTRUCTION. The date of permit issuance
for new construction and substantial improvements to existing
structures, provided the actual start of construction, repair,
reconstruction, rehabilitation, addition, placement or other
improvement is within 180 days after the date of issuance. The
actual start of construction means the first placement of perma-
nent construction of a building (including a manufactured
home) on a site, such as the pouring of a slab or footings, instal-
lation of pilings or construction of columns.
Permanent construction does not include land preparation
(such as clearing, excavation, grading or filling), the installa-
tion of streets or walkways, excavation for a basement, foot-
ings, piers or foundations, the erection of temporary forms or
the installation of accessory buildings such as garages or sheds
not occupied as dwelling units or not part of the main building.
For a substantial improvement, the actual "start of construc-
tion" means the first alteration of any wall, ceiling, floor or
other structural part of a building, whether or not that alteration
affects the external dimensions of the building.
SUBSTANTIAL DAMAGE. Damage of any origin sustained
by a structure whereby the cost of restoring the structure to its
before -damaged condition would equal or exceed 50 percent of
the market value of the structure before the damage occurred.
SUBSTANTIAL IMPROVEMENT. Any repair, reconstruc-
tion, rehabilitation, addition or improvement of a building or
structure, the cost of which equals or exceeds 50 percent of the
market value of the structure before the improvement or repair
is started. If the structure has sustained substantial damage, any
repairs are considered substantial improvement regardless of
the actual repair work performed. The term does not, however,
include either:
1. Any project for improvement of a building required to
correct existing health, sanitary or safety code violations
identified by the building official and that are the mini-
mum necessary to assure safe living conditions.
2. Any alteration of a historic structure provided that the al-
teration will not preclude the structure's continued desig-
nation as a historic structure.
1612.3 Establishment of flood hazard areas. To establish
flood hazard areas, the governing body shall adopt a flood haz-
ard map and supporting data. The flood hazard map shall
include, at a minimum, areas of special flood hazard as identi-
fied by the Federal Emergency Management Agency in an
engineering report entitled "The Flood Insurance Study for
[INSERT NAME OF JURISDICTION]," dated [INSERT DATE OF ISSU-
ANCE], as amended or revised with the accompanying Flood
Insurance Rate Map (FIRM) and Flood Boundary and Floodway
Map (FBFM) and related supporting data along with any revi-
sions thereto. The adopted flood hazard map and supporting data
are hereby adopted by reference and declared to be part of this
section.
2003 INTERNATIONAL BUILDING COr
1612.4 Design and construction. The desig and construction
of buildings and structures located in fl s od hazard areas,
including flood hazard areas subject to h'gh velocity wave
action, shall be in accordance with ASCE 2- .
1612.5 Flood hazard documentation. Th- following docu-
mentation shall be prepared and sealed by . registered design
professional and submitted to the building • fficial:
1. For construction in flood hazard ar
high -velocity wave action:
1.1. The elevation of the lowest flo
ment, as required by the lowes
spection in Section 109.3.3.
1.2. For fully enclosed areas belo
elevation where provisions to allow for the auto-
matic entry and exit of floodwaters do not meet
the minimum requirements in Section 2.6.1.1,
ASCE 24, construction documents shall include
a statement that the design will provide for equal-
ization of hydrostatic flood forces in accordance
with Section 2.6.1.2, ASCE 24.
1.3. For dry floodproofed nonresidential buildings,
construction documents shall i clude a statement
that the dry floodproofing is esigned in accor-
dance with ASCE 24.
2. For construction in flood hazard areas ubject to high -ve-
locity wave action:
2.1. The elevation of the bottom f the lowest hori-
zontal structural member as required by the low-
est floor elevation inspection in Section 109.3.3.
2.2. Construction documents shall include a state-
ment that the building is designed in accordance
with ASCE 24, including that the pile or column
foundation and building or structure to be at-
tached thereto is designed to be anchored to resist
flotation, collapse and lateral movement due to
the effects of wind and flood loads acting simul-
taneously on all building components, and other
load requirements of Chapter 16.
2.3. For breakaway walls designed to resist a nominal
load of less than 10 psf (0.48 kN/m2) or more than
20 psf (0.96 kN/m2), constriction documents
shall include a statement that the breakaway wall
is designed in accordance wit)i ASCE 24.
as not subject to
.r, including base -
floor elevation in -
the design flood
SECTION 1613
EARTHQUAKE LOADS DEFT ITIONS
1613.1 Definitions.The following words d terms shall, for
the purposes of this section, have the meanin s shown herein.
ACTIVE FAULT/ACTIVE FAULT TRACE. A fault for
which there is an average historic slip rate o 1 mm per year or
more and geologic evidence of seismic act vity within Holo-
cene (past 11,000 years) times. Active fault traces are desig-
nated by the appropriate regulatory agency and/or registered
design professional subject to identification by a geologic
report.
2003 INTERNATIONAL BUILDING CODE®
STRUCTURAL DESIGN
ATTACHMENTS, SEISMIC. Means by which components
and their supports are secured or connected to the seis-
mic -force -resisting system of the structure. Such attachments
include anchor bolts, welded connections and mechanical fas-
teners.
BASE. The level at which the horizontal seismic ground
motions are considered to be imparted to the structure.
BOUNDARY ELEMENTS. Chords and collectors at dia-
phragm and shear wall edges, interior openings, discontinuities
and reentrant corners.
BRITTLE. Systems, members, materials and connections that
do not exhibit significant energy dissipation capacity in the
inelastic range.
COLLECTOR. A diaphragm or shear wall element parallel to
the applied load that collects and transfers shear forces to the
vertical -force -resisting elements or distributes forces within a
diaphragm or shear wall.
COMPONENT. A part or element of an architectural, electri-
cal, mechanical or structural system.
Component, equipment. A mechanical or electrical com-
ponent or element that is part of a mechanical and/or electri-
cal system within or without a building system.
Component, flexible. Component, including its attach-
ments, having a fundamental period greater than 0.06 sec-
ond.
Component, rigid. Component, including its attachments,
having a fundamental period less than or equal to 0.06 sec-
ond.
DESIGN EARTHQUAKE. The earthquake effects that build-
ings and structures are specifically proportioned to resist in
Sections 1613 through 1622.
DESIGNATED SEISMIC SYSTEM. Those architectural,
electrical and mechanical systems and their components that
require design in accordance with Section 1621 that have a
component importance factor, I, greater than one.
DISPLACEMENT.
Design displacement. The design earthquake lateral dis-
placement, excluding additional displacement due to actual
and accidental torsion, required for design of the isolation
system.
Total design displacement. The design earthquake lateral
displacement, including additional displacement due to ac-
tual and accidental torsion, required for design of the isola-
tion system.
Total maximum displacement. The maximum considered
earthquake lateral displacement, including additional dis-
placement due to actual and accidental torsion, required for
verification of the stability of the isolation system or ele-
ments thereof, design of building separations and vertical
load testing of isolator unit prototype.
DISPLACEMENT RESTRAINT SYSTEM. A collection of
structural elements that limits lateral displacement of seismi-
cally isolated structures due to the maximum considered earth-
quake.
301
%tri 4
I pakane
Valley
CITY OF SPOKANE VALLEY
Community Development Department
Current Planning Division
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Tel: (509) 921-1000
Fax: (509) 921-1008
plannincq@sookanevallev•ora
(For Staff Use Only)
DATE SUBMITTED: RECEIVED BY:
FILE NO./NAME:
CURRENT PLANNING FEE:
ENGINEERING FEE:
MAY 0 2001
FLOODPLAIN DEVELOPMENT APPLICATION
PART I — APPLICATION INFORMATION
APPLICANT INFORMATION:
APPLICANT: TO (AA f ftvn of
MAILING ADDRESS:
CITY: \1:.^c:, rJ+✓
STATE: ti/ ZIP: C1
PHONE: (HOME/WORK) .3i_C - 2-118 3 (FAX) 3 Z v (I -1'i'+.% (CELL) v T) is 1- tJ
Please Circle
NOTE: IF APPLICANT IS NOT THE OWNER, INCLUDE WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW:
OWNER INFORMATION:
LEGAL OWNER: ' 6? c. , ,- -\c
1
MAILING ADDRESS: ii A v (: r
CITY: 5 p,-- k Jit, 1 I c r STATE: a.J A
PHONE: (HOME/WORK) c3Ci 2 - 3t; i i FAX) (CELL)
Please Circle (509
ZIP: ci'i Zi;4
PART II — SUBMITTAL REQUIREMENTS
All Floodplain Permit Applications shall contain the following required information. If required and not
submitted, the application will be returned to the applicant as incomplete:
❑ Three (3) to -scale (minimum scale is 1 inch = 20 feet) site plans showing the nature, location,
dimensions and elevation of the property and identifying the portion of the property located within
the designated floodplain, existing or proposed structures, location of proposed fill, location of
storage of materials, and the location of drainage facilities.
Proposed elevation in relation to mean sea level of the lowest floor including basement of all
structures
Proposed elevation in relation to mean sea level for any structure that has been flood -proofed.
For non-residential construction only, certification by a registered professional engineer or
architect that flood -proofing methods for any non-residential structures meet the flood -proofing
criteria of Section 5.06.08.2 of the City's Floodplain Ordinance.
Written description if applicable describing the extent to which a watercourse will be altered or
relocated as a result of the proposed development.
0
No Rise Certification.
Version 2 04-05
4
PARCEL NUMBER(S) OF SITE:
PART III — PROJECT INFORMATION
STREET ADDRESS OF SITE (if any): 'iu'1
:-.41,
L,.r 5oo \,f 11A7 tJ14 'l4Zc�,
SIZE OF SUBJECT PROPERTY (square feet): ) s�o 5 4 i
EXISTING ZONE CLASSIFICATION(S):
LIST PREVIOUS LAND USE ACTIONS INVOLVING THIS PROPERTY:
Areas of Special Concern: Pursuant to Section 5.06.13 of the Spokane Valley Floodplain
Ordinance, the following areas shall not be covered by impervious surfaces or fill unless an
engineering study prepared by a professional engineering licensed in the State of Washington is
completed that shows no impact to the ability of the floodplain to infiltrate, store and release
floodwaters. Please check the box if your property is located in one of these areas:
❑ Chester Creek (downstream of Mohawk Road)
❑ Saltese Creek (all areas of ponding and infiltration)
❑ Forker (south of the intersection of Forker Road and Progress Road)
❑ Central Park (west of Park Road)
❑ Glenrose (west of Carnahan Road and south of 8th Avenue)
DESCRIPTION OF WORK:
1. Proposed Development Descriptions (check boxes that apply):
❑ New Construction
❑ Alteration & Repair ❑ Stream Alteration
', Manufactured/Modular Housing ❑ Road, Culvert, Utilities
❑ Other - Describe:
2. Types of Construction (check boxes that apply):
❑ New or Existing Residential: square feet
❑ Addition: square feet
❑ Accessory Structure: square feet
❑ Renovation: ❑ Interior ❑ Exterior
❑ Temporary
El New Non -Residential
❑ Repair
❑ Utility Installation
❑ Other - Describe: rc, LA 5 � ✓A^ar.,) <
For Alterations, Additions or Improvements to an Existing Structure: If the cost of the
proposed construction equals or exceeds 50 percent of the market value substantial
improvement requirements shall apply. Please answer the following questions:
a. What is the estimated market value of the existing structure?: $
b. What is the estimated cost of the proposed construction?:$
I- L...-_
Version 2 04-05 2
3. Filling & Grading (check boxes that apply):
❑ Filling .
❑ Grading
❑ Cubic Yards to be Removed: cubic yards
❑ Cubic Yards to be Placed: cubic yards
ASSOCIATED APPLICATIONS:
This permit is being applied for in conjunction with one or more of the following (check boxes):
❑ Residential/Commercial Building Permit ❑ Grading Permit ❑ Land Division Application
❑ Critical Areas Permit ❑ Shoreline Substantial Development Permit
❑ Other - Describe:
PART IV - LEGAL OWNER SIGNATURE
(Signature of legal owner or representative as authorized by legal owner)
1, , (print name) SWEAR OR AFFIRM THAT THE
ABOVE RESPONSES ARE MADE TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE.
I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA
PROPOSED FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER,
ATTACHED HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY
ACTIONS ON HIS/HER BEHALF.
It is hereby agreed that the City of Spokane Valley, its boards, officers, employees and agents shall be
saved, indemnified and held harmless from all liabilities imposed by law by reason of injury to or death
of any person(s) or damage to any property, including without limitation, liability for trespass, nuisuance
or inverse condemnation, which may arise out of the work covered by this permit, and does agree to
defend the City, its officers, employees and agents against any claim or action asserting such liability.
Accepting this permit or starting any work hereunder shall constitute acceptance and agreement to all
conditions and requirements of this permit and the ordinance and specifications authorizing issuance of
such permit.
STATE OF WASHINGTON ) ss:
COUNTY OF SPOKANE )
SU SWORN to be
Version 2 04-05
NOTARY
(For Part IV above)
(Date)
day of , 20
AT RE
Notary Public in and for the State of Washington
Residing at: Loop c.
My appointment expires: /-'L- 11- tZ'
3
cJaTrodl
PART V — CONDITIONS OF APPROVAL
FOR INTERNAL USE ONLY - TO BE COMPLETED BY THE CITY OF SPOKANE VALLEY
Community Number:
530-342
Panel Number.
.02-{'
Flood Zone:
A 4
Flood Zone Depth No.:
Base Flood Elevation at Site:�
j -'
�,We,� � �
Required
c
3Cz
e,�-a
Required Top of the Next Higher Floor Elevation:
,,�/4 .
If the structure is to be floodproofed, the required
floodproofing elevation or method is:
W r5 z-t2t7
'—
i''' -c
L"'`u
Elevation to which all attendant utilities including((
heating, ductwork, plumbing ventilation, electrical
equipment and other service facilities will be
installed or waterproofed:
-9))i
Elevation Certificate Required:
Yes
❑ No
Conditions of Approval: In addition to those listed above and below, please refer to attached
conditions of approval if applicable.
1. Required Elevation of the "top of the next higher floor" shall be (AE) feet M.S.L.
2. Required Elevation of the "top of the next higher floor" shall be (AO) feet M.S.L
3. Required elevation of flood resistant materials, utilities, etc. or floodproofing construction for non-
resdiential structures (the flood protected elevation) shall be t`7 ' feet M.S.L.
4. A "Building Under Construction" elevation certificate ® shall ❑ shall not be completed and
submitted to the City for review and approval prior to any vertical construction. A "Finished
Construction" elevation certificate Ya shall ❑ shall not be completed and submitted to the City for
review and approval prior to human occupancy or final inspection of on-site building(s), whichever
comes first. NO HUMAN OCCUPANCY OR FINAL INSPECTION SHALL BE GRANTED PRIOR
TO THE SUBMITTAL AND APPROVAL OF THE "FINISHED CONSTRUCTION" CERTIFICATION.
b e -L.
uLa
0
.e Lv,
Version 2 04-05
4
•
CILI-i-cty-j
PART VI — DEPARTMENT SIGN -OFF & APPROVAL
The following City Departments have reviewed and approved the floodplain permit application and have
determined that conformance to applicable conditions of approval have occurred as required through
the issuance of the permit:
City of Spokane Valley Community Development Department:
As the Floodplain Administrator or designee for the City of Spokane Valley, I certify the following has
been reviewed and approved by me:
❑ The "No Rise" Certificate submitted to support the proposed floodplain development is approved.
The "Building Under Construction" elevation certificate has been reviewed and approved:
❑ Structure elevated BFE + 1 foot
❑ Structure built with waterproofed materials to the flood protected elevation or more
4 «o� . - Mt ---- . zr� h��1c1�ca-r
Floodplain Administrator or Designee Date
The "Finished Construction" elevation certificate dated: , 20 . It has been
reviewed and:
U Returned for more information on , 20 ;
❑ Approved on , 20 ;
Floodplain Administrator or Designee
Date
❑ For unnumbered A Zones the Spokane Valley Building Inspector will verify that the first floor and all
related mechanical and electrical equipment is two feet above adjoining flood area.
Floodplain Administrator or Designee
Date
PLEASE NOTE: THIS PERMIT SHALL EXPIRE WITH THE ISSUED BUILDING PERMIT OR IF
THERE IS NO BUILDING PERMIT WITHIN TWELVE MONTHS OF THE DATE OF ISSUANCE IF
ACTIONS AUTHORIZED UNDER THE PERMIT ARE NOT SUBSTANTIALLY IN -PROGRESS.
EXTENSIONS OF APPROVAL MAY BE SOUGHT IF SUBSTANTIAL PROGESS HAS TAKEN
PLACE.
Version 2 04-05
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program .
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-8.
OMB No. 1660-0008
Expires February 28. 2009
SECTION A - PROPERTY INFORMATION
For Insurance Company Use:
Al. Building Owner's Name Wayne Hayes
Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
908 South Nina Circle
Company NAIC Number
City Spokane Valley State WA ZIP Code 99206
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
APN45203.0133
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 47.6483 Long. 117.2788
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood •i
A7. Building Diagram Number 8
A8. For a building with a crawl space or enclosure(s), provide A9. Fa.
a) Square footage of crawl space or enclosures) 1400sq ft a)
b) No. of permanent flood openings in the crawl space or b) ''-
enclosure(s) walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b
sq in
SECTION B - FLOOD INSURANCE RATE MAP (I' -
B1. NFIP Community Name & Community Number
530174
B2. County Name
Spokane
B4. Map/Panel Number
294
B5. Suffix
C
B6. FIRM Index
Date
5/17/88
B7. FIRM Panel
Effective/Revised Date t_
9/30/92
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in
0 FIS Profile ® FIRM 0 Community Determined 0 Other (Desi.-`
B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 0 NAVD 1988 :-
B12. Is the budding located in a Coastal Barrier Resources System (CBRS) area or Otherwise f-'
Designation Date 0 CBRS 0 OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ® Construction Drawings* 0 Building Under Construction* 0 Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized USGS P485 Vertical Datum 1929
Conversion/Comments
a) Top of bottom floor (including basement, crawl ace, or enclosure floor)_
ii'A/
.
b) Top of the next higher floor
c) Bottom of the lowest horizontal reetcar l ember,(V Zunea unljl)
d)
e)
f)
9)
Attached garage (top of slab)
Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment in Comments)
Lowest adjacent (finished) grade (LAG)
Highest adjacent (finished) grade (HAG)
Check the measurement used.
1985.8 ® feet 0 meters (Puerto Rico only)
0 feet 0 meters (Puerto Rico only)
1989.1 0 feet 0 meters (Puerto Rico only)
N/A. ® feet 0 meters (Puerto Rico only)
1989.0 ® feet 0 meters (Puerto Rico only)
1985.7 ® feet 0 meters (Puerto Rico only)
1986.1 0 feet 0 meters (Puerto Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
® Check here if comments are provided on back of form.
Certifier's Name Jeff Wiley
License Number 22354
Title PLS Company Name LandTek, LLC
Address 619 No h Ma li Str t City Spokane
Signature
Date 4/18/07
State WA ZIP Code 99202
Telephone 509-926-2821
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
908 South Nina Circle
For Insurance Company Use:
Policy Number
City Spokane Valley State WA ZIP Code 99206
Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments Existing manufactured home to be removed and replaced. City of Spokane Valley has determined a minimun of 36 inches between highest
adjacient grade and the lowest po ion of the manufactured home.
Signature
Date 4/18/07
® Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawl space, or enclosure) is 0 feet 0 meters 0 above or 0 below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure) is 0 feet 0 meters 0 above or 0 below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is 0 feet 0 meters 0 above or 0 below the HAG.
E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or 0 below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? 0 Yes 0 No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E am correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address
City
State ZIP Code
Signature
Date Telephone
Comments
0 Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E),
and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.
G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. 0 A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO.
G3. 0 The following information (Items G4. -G9.) is provided for community floodplain management purposes.
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building:❑ feet 0 meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum
Local Official's Name
Title
Community Name
Telephone
Signature
Date
Comments
Building Photographs
Continuation Page
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
908 South Nina Circle
Policy Number
City Spokane Valley State WA ZIP Code 99206
Company NAIC Number
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."
rxtTrntC. i'foMcZ Teo eG R‘MoUGrQ
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
908 South Nina Circle
Policy Number
City Spokane Valley State WA ZIP Code 99206
Company NAIC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
I(t ST 1 Ai (o N oM,C `To QE RE -en o J O