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2003, 08-18 Permit App: BLD-03-02252 Pole BarnL Sji 400Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION 1 STREET ADDRESS: 35`0 ASSESSOR'S TAX PARCEL NUMBER(S): + 5-0 31e At LEGALDISCRIPTION: 5� x d `T,142_ v - PERMIT DESCRIPTION: U1LDING PERMIT }RELOCATION CI CHANGE IN USE D GRADING (� SIGN Q TENANT D MANUFACTURED HOME -OTHER OWNER / APPLICANT INFORMATION ® OWNER: i �/4 1.6e,,— PHONE: FAX: ® APPLICANT: G1 7-10. - S- PHONE: 2' ? L d S�� . FAX: ADDRESS: �� I /10,kFl% ,53-7-2c,c=7 CITY, STATE, ZIP ADDRESS: CITY,STATE, ZIP °CONTRACTOR: Cl r54 -2e / 0 q ARCHITECT: PHONE: -22 f 7 / FAX: PHONE: ADDRESS: ADDRESS: L' 9A99 /074x v -'r // IA l/` � S 455-7-6- Q � -CITY,. STATE, ZIP 4yb WA ST CONTRACTOR LICENSE 5 / �`` .f 972 LF FAX: CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: BUILDING HEIGHT TO PEAK: 110 BUILDING DIMENSIONS: NUMBER OF STORIES: NUMBER of BEDROOMS: FLANKING SETBACK: FRONT SETBACK: REAR SETBACK: LEFT SETBACK: RIGHT SETBACK: 30% SLOPES ON PROPERTY: OCCUPANCY GROUP: CONSTRUCTION TYPE: STRUCTURES ON PROPERTY: CRITICAL AREAS: CURRENT PROPERTY SIZE: CURRENT PROPERTY USE: CURRENT SEPTIC USE: CURRENT WELL USE: IMPERVIOUS SURFACE AREA: MAIN FLOOR SQ FT: 2ND FLOOR SQ FT: UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: COVERED DECK: DECK: 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: WA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: ADDRESS: PHONE: FAX: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS 0 BOLTING FIRM NAME: INSPECTOR(S): 0 CONCRETE 0 REINFORCEMENT PHONE: 0 WELDING FAX: BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: 0 YES 0 NO IS PUBLIC WATER AVAILABLE: ▪ YES ▪ NO IF YES: ▪ COUNTY • CITY 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 NO PSSA: 0 YES 0 NO DATE: METHOD OF PAYMENT.• O 0 1 CASH CHECK BANKCARD A#; EXP/RES: V/N# AUTHOR/ZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD STAFF: 1 08/1b/2UUJ /1/2niYJdZ417b / AUG 15 2003 11:09 FR r JrcnQ CMJ TO 3241567 F' •-- v i3r�Se Pd'rA e- ** TOTAL PAGE.03 ** AUG 15 2003 11:31 5093241567 PAGE.02 na/ 1C/ LGGJ 1G:4.7 JG7JL41J0 FINAL ..AS18Ui6 .INSTqtIAi101V tcrCA''TION OF THE ON-SITE S!'4'1 ise $YMTEM REPRESENTED BY THE DRAW IS NOT TO BE CONSTRUED A5.404 EXACT LOCATION OF THE SYSTIM, REMARKS (continued)' • AUG 15 2003 10.44 5093241567 PAGE.01 N APPROVED B o q 1� /A/ 3rtS C'J,, Avo_