2004, 05-17 Permit App: BLD-04-04385 Garage ._-_- N .c-i---
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v , BUILDING PERMIT APPLICATION WORKSHEET
*Mane
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
.000Valky 1::2-,
J `t - Phone: (509) 688-0036;Fax: (509) 688-0037
EQIRED ITE INFORMATION
Street Address: 1317 5, 171 pt�S '
Assessor's Tax Parcel Number(s): t-1 3`r. 1(2
52 0 7
Legal Description:' ? -(n0 / a I%5-10 ?5 (o'/6 D r-
PERM T DESCRIPTION: 'Z / 2-2- tJL r L.O4- 6'A1214 e • 1 b7
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
"Owner: 66644e 1144x,12 ❑ Applicant:
Phone: 9Z4-�33? Fax: �?„4- ?L{7 L Phone: Fax:
AAddr�e,Bss:!/ N7 Si e2Dct �S 09-1) Address:
CitySiPnry"w� v State Zi��ode City State Zip Code
El/ Contractor: (4 S'- -L L.. ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License #: L$5 ag71-LF Contact: 7J I44 Z75 9S77
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK 16 1 DIMENSIONS: 1,4,x Z7_ #OF STORIES:
MAIN FLOOR TO-SQ. FTG flu FLOOR SQ. FTC: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: 521 DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYP HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJE 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
36 SYSTEM?
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
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: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
El BOLTING ❑ CONCRETE ❑ REINFORCEMENT El WELDING
Firm Name: Phone: Fax:
Inspector(s):
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 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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash 0 Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
12TH AVENUE *,
r R.R. SPIKE B OK6 7
4a d sPacE )/ER A
......,-
f—) ' to ��r LOT 4
N.89 4$'2g"W. 1" x 42
:\
N' m - 13`'BORDER EASEMENT 7
344.004
,+ , 106.00' e
Q \-, , L 30.ao 213.00 I
25.0
-• AiRAc.�
....-1a' UTILITY LOO : 2 l
Z 0 EASEMENTN .' . Th._ t cr} S H-
N.
1 10.176 s.f. ot #--
Li I t3_ S. (n
116N .
F N a el 6i I 35' SETSA . 5T. W z_UNE
2SETBACK1 ,�,
1. Z.i •
alt GJ UNE OIJSE� 'i 108.00' w
m ' a t•• cc ORAINFI t -U
r i Abq,4 ° G '� -� ss9.48'2$ <Q
f`1 iI! J;' ' - g T N T a 5
! Z ke,t 40,896 s.f. - ;94 -al .,z I t
. .g 0 N:1 S. 1317 S 10,178 s.f. cn
[] r ct°i� $. 1324 I1'4'
" ?` 1 4 5te .00' FUTURE ACQUISITION AREA 10' t)T1t iTY ""'
' EASEMENT
30.00' { 25.(
1 213.00' .
106.00'i 1 j
i � oda' . '�
34w4.00' 25
Po a � � N.$9'4$'28"W.
$,,�. T
or"D►C�liont � 8 8 � 25'
BLOCK liT�
KNOW ALL MEN BY THESE PRESENTS, that'Kenneth W. Ernert and Dorothy L Emer't, B L O C K v�i
N.A.. have- platted Into lots Lot 4
husband and wife, and First Interstate Bank c►f Oregon SHORT as PLAT N0. 1046--95, I W Lot 4 i
and streets the land'shti hereon to be known
Said plat being more particularly described as follows: .; r` County
ty
rol
OF BLOCK 16'1. VERA AS , , i
ME SOUTH 192.00 FEET OF TME WEST 344.00,FIS The taw
PER PLAT RECORDED
IN BOOK -Cr OF PLATS, PAGE 30, SPOKANE COUNTY. 1 ' and (
,
c
��"" and o
WASHINGTON. � the Pc
The owners hereby dedicate to Spokane County. for public' use forever, of the
the streets shown hereon- si
pursuant to the Water Plan approved by county'and state health �� theor dei
The public wtrtsr, systern, ant and water assert
authorities, the toad fire protection district, County Building and Safety Department
ii purveyor, shall be installed within this subdivNtion, a►d the c rpiicatt shat provide far ' �, {N
individual domestic water ser4ce as well es fire protect to each tract prior to sale of each �'�
for each tract. t� IHIS
N
tract and prior to issuance of a building permit _ ;
1