2003, 09-26 Permit App: BLD-03-02605 GarageSpick ne'
Malley
STREET ADDRESS*
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BU/LD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206.
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION J
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: ,29 'x met'
%BUILDING PERMIT
CI CHANGE IN USE
®RELOCATION ®SIGN
O GRADING 0 MANUFACTURED HOME
®TENANT ®OTHER
OWNER / APPLICANT INFORMATION
® OWNER: ,- L - /PE Z-1,6
PHONE: 4'e '5 ' O6Is 5 -FAX:
® APPLICANT:
PHONE: FAX:
ADDRESS: /I2c --/2 , dew, ADDRESS:
jJ CITY,STATE, ZIP CITY, STATE, ZIP
®CONTRACTOR: /2�/ri"+-`3e ® ARCHITECT:
PHONE: 02 is /S c7 FAX: ,P9& /56j PHONE: FAX:
ADDRESS: .2&."3:2)."&S7 r��'t 4'� �' DDRESS:
CITY, STATE, ZIP
/ CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE %/9'7FS '9 / 9376239CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: o,-PG'Y re. 30% SLOPES ON PROPERTY:
I
BUILDING HEIGHT TO PEAK: /1 OCCUPANCY GROUP:
BUILDING DIMENSIONS: o79 XIV CONSTRUCTION TYPE: W /e arm
NUMBER OF STORIES: /
NUMBER of BEDROOMS: ( J
FLANKING SETBACK:
FRONT SETBACK: 7�o CURRENT PROPERTY USE: 421'
REAR SETBACK: '571 CURRENT SEPTIC USE:
i
LEFT SETBACK: ‘9 CURRENT WELL USE:
RIGHT SETBACK: 6 IMPERVIOUS SURFACE AREA:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE: /037c S-31
MAIN FLOOR SQ FT:
2ND FLOOR SQ FT:-
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE: S7('p 4.;--/�
COVERED DECK:
DECK:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
�1190,110.
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: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATEITIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
® BOLTING °CONCRETE 0 REINFORCEMENT a WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: ® YES a NO
O 0
IS PUBLIC WATER AVAILABLE: YES NO
IF YES: • COUNTY
® CITY
IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: ® YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES ® NO
DATE:
STAFF:
METHOD OF PAYMENT.:
CASH CHECK
VISA
BANKCARD #; EXPIRES: VIN#
AUTHORIZED SIGNATURE'
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
PAGE 01/01
0
NN
09/26/2003 13:53
B4 ,32'
110.04'
2 9.9 6 `---ti►
14t-20.04
c
35'
1
7.95'
Y.
ST
20.05`-101 T10.0
5 0
35'
r
I
(1b
4 4.07'----'—Ows
( 20 '1'o M,wFa, a:4.;,1
/4957° E rn 4;, e AJ
,15'
APPROVED BY
c� R G.c-vL-2 q/zeeg3
509324156?
SEP 23 2003 13:56