2002, 10-09 Permit App: 02008908 Storage BldgI I
ngr.
Spo w' COUNTY
PROJECT APPLICATION WORK SHEET
SPOK.\NE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 \VEST BROADWAY AVENUE
SPOKANE, \'Q\ Q0260
509-177-3675
/ /� SPECIFIC SITE INFORMATION
Street Address: /� I 1 1.3 3aq �' /D rA
\ssessor's Tax Parcel Number(s):"/ V ,/
Legal Description
Project Description: elAj �[T
yfi Building Permit
Cl Relocation
O Change to Use
/__61.47 bit
O Grading
CI \lanufactured l-Ioo\e Permit
O Sign
O Tenant (New/Change)
Cl Other
Department Use Only
\\ :Per Dnma/Punyn
Server Davin/bun crtr
Road width
Setback.
Front Rear
Leh Right
Schn,1 Disvat
Fire Dia nu: -
toning
OWNER/APPLICANT INFORNIATION
IvJx.rh n/h Iuiu/,llv,.l,;1✓JeJre*thlInIbn pm/
PROTECT INFORMA'T'ION
Pima, g -o 9 -q'
78x7
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Sem
p„,„,,GJi
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l a� /o,x
n1,g -wd,e••
03a -If , 6Upr�
Main Moor ay ti.
matting \dd1...
tintln,.hul bp, rnm ..y G.
te.ti' a I
9 9�6
plata. ,I,,
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I.n
Matting .old e..N13111,1;4addr,..
L Slid,
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car.igt xl It
Dtcb sq It
lar. gum
JCS
t:nr Oar Zip
n f
0 v 6 �Jl��
\\'l Stale Comr,uun heen.e a
(onua nano
PROTECT INFORMA'T'ION
Building Information
Rwli ci ht to pcak
# atune.
Main Moor ay ti.
tintln,.hul bp, rnm ..y G.
.I hnu nvl,n',
g ilxJo
If lvbitablc space
""•I 0,„,, -.Li It
A-
I'In1.hal bv.cin, yr! :“.1. It
l henpanc, group
cutvnucnuntrpc
car.igt xl It
Dtcb sq It
I:u.t or project ,l
�r(r�
JCS
I le.0 sou« r (e4ane. gat. tic)
/l/bJ�
n f
0 v 6 �Jl��
DIJCOVER_
Manufactured Home
Sign
with!,
1 ngth
Witt li the sit uac foouge of the sign
face?
I loll' high la the sign%
Year
Make
# of signs
Area of existing 51515
Ftrc1 (irks Jlspia,
_
I).ut erna.rd
Po)pi,scd use
Relocation
Fire Safety
Pin,,Nvne
What is the et v 01 050 of this pin x'rty'?
TT)fit
Prei Ions address
Will the site to sen ed hl a septic system? ❑ Yes fiesiNo
Fire Sprinkler
i
'hent
Paint booth P1re .11 arm
Ftrc1 (irks Jlspia,
_
I).ut erna.rd
Po)pi,scd use
Value
AdJri..
Special Inspections Required?
Non -Residential Energy Code Compliance?
Pin,,Nvne
What is the et v 01 050 of this pin x'rty'?
TT)fit
Is your property uta designated wildlife habitat area?
0 Don't know 0 Yeso
Will the site to sen ed hl a septic system? ❑ Yes fiesiNo
Phone
Are or will there be wells located on the property=
/ Per. ti n/ijy on the we plan 0 Yes ANO
Plan, IAaminer
Phone
Imp( nt.
Arc critical or ha/ardour)materials used or storedoil vtr+
0 Yes _...5No
I).ut erna.rd
soil k.pn.cnumo
AdJri..
In.Pcrelr
Phone
0 Concrete
0
Welding
0
Bolting
0 Reinforcement
AJJre..
ADDITIONAL SITE INFORMATION
Are there structures on the propetty> 0 Yes 0 No
If let lllPlll/�)'0// 0/0 plan(sill
what is the current propene si>e> / � 9
laIe feet 1n at res)
Is ane part of the property 'ohm 250 feet of n shoreline?
If lei. hfenbji on me plait 0 Yes 0 No
What is the et v 01 050 of this pin x'rty'?
TT)fit
Is your property uta designated wildlife habitat area?
0 Don't know 0 Yeso
Will the site to sen ed hl a septic system? ❑ Yes fiesiNo
15 any pan of the property vIrhui a 1001 r flood plain?
ll_rer /rindify on site pint
0 \lavbe ❑ Dtnl t know ❑ Yes No✓✓✓
Are or will there be wells located on the property=
/ Per. ti n/ijy on the we plan 0 Yes ANO
.Ire (here ane vellnnds, streams or ponds within _ feet of the property!
I/ let. Jdenn/j, on etre peon ❑ Yes ❑ No
Is there evidence of fill or exavanon nn the propeirv5 �/
.il
❑ Yes No
Are there slopes greater than WI "'„ nn the property? (32;c in 1!1(I ft
(_/':..j 0 Yes
Arc critical or ha/ardour)materials used or storedoil vtr+
0 Yes _...5No
DEPARTMENT USE ONLY
Is the properly in a designated Stonnwater Control, l rea?
❑ Yes
❑
No
Is public sewer available to the sire? 0 Yes 0 No
Is the property inside the ASA? 0 Yes
❑ Yes
0
0
No
No
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA> 0 Yes
0
No
Is the property located within 1000 feel of a Natural Resource Area>
0 Yes 0 No
I).ut erna.rd
soil k.pn.cnumo
METI IOD OF PAYMENT
VISA
❑ I:\sly ❑ fl incl. 9 MOM❑
FAXED PERNIITS WILL ONLY I3E ACEI'TED WITH PAYMENT OFA MAJOR CREDIT CARD,
I•NI'Iltf>
It \Nhc,\IID NI.1:11B1
\U I 1 I(AtI%I'.D SIGNS! URI
SUB I Of\I.
TOTAL FEE
,1I1,VLIIL )f PERMIT FEE 13 535.001131 \Sli
'1\ AI,0II C.A$ r'.Vl \611aostok \\I'.
r:o -v T PER\II l Cf\ I ER
EAGLE
WINDOWS- DOORS
/o32,Y (Vvr�
EAGLE WINDOW & DOOR, INC.
P.O. Box 1072, 375 East Ninth St.
Dubuque. IA 52004 - 1072
(319) 556 - 2270
FAX (319) 556 - 3825
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