2000, 05-30 Permit App: 00004294 Re-Roof 1 , I PROJECT APPLICATION
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SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
MI SPOKANE,WA 99260
SPoi< i Cowry 509-477-3675
Project Description:
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TYPE OF APPLICATION
ABuilding Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
Department Use Only „-
Inter Disinet/Purveyor; ` ' Sewer District/Purveyor' Road width Setbacks
Front: Rear:
School District:.. Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
❑Owner. Phone: ❑Applicant: Phone:
Fax: Fax:
Mailing Address: Mailing Address:
City,State,Zip City,State,Zip
Contractors „ Phone 5.-09 3S 3?9 ❑ Architect/Engineer Phone
'iC,l�( PAZ ) t s'1� ��5CA.(n Fax
Fax
Mailing address J_I I/ .' Mailing address
1q-25 to
City,State Zip SCity,State Zip
WA State Contractor Iite se N Contact name:
S'l/ Y' Lr /1-So 3gN14
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of projectHeat source(electric,gas,etc.)
'88 a
Y
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special=Inspections.Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No What is the current property size?
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan O Yes O No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes O No
O Don't know O Yes O No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,idents on site plan If yes,identify on the site plan O Yes O No
O Maybe O Don't know O Yes O No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes El No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( /%) O Yes O No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Storrnwater Control,Area? " Is public sewer available to the site? O Yes 0 No
O Yes O No
Is the property inside the ASA? El Yes O No Is public water available to the site? O Yes 0 No
O Yes O No
Is the property inside the PSSA? O Yes O No Is the property located within 1000'feet of a Natural Resource
Area? O Yes El No
Date Received: Staff Representative: