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2003, 09-24 Permit App: BLD-03-02576 Addition so1� . ..Malley PERMIT APPLICATION WORK SHEET SPOKANE VALLEYCOMMUN/TY DEVELOPMENT BUILDING DIV/S/ON 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: yi 0 �o S Y ' ' D ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: PERMIT DESCRIPTION: 0 BUILDING PERMIT CI CHANGE IN USE 0 GRADING a MANUFACTURED HOME URELOCATION E SIGN [TENANT E OTHER OWNER / APPLICANT INFORMATION ® OWNER:CZ✓f f r-4- A t N-Ar4 A)f 4 I 4--ti 0 APPLICANT: --5-X-r l-v/U$(4� /L r' PHONE: /�//__Z_`-3 -/S( FAX: PHONE: -22'/Y ' 30 /I FAX: E 0)'/P2 Y'' ADDRESS: o 42 IA oJ �7 to-0ADDRESS: I / / ? e /4--),;,Pe/do / 7 ,j 414 ( CITY,STATE,ZIP 9' J6L( CITY,STATE,ZIP ®CONTRACTOR:,--< L ( C2,-) .e I. elito.:.-) ® ARCHITECT: L _ t/ � .=�`�kK Eiti�-! r-;��.� ca /..� PHONE: 4 _3°1( FAX: .-3.2, ?� a W??'? PHONE: //1 3 4) �(0 FAX: ,/r<{J"- 6 Ste& 1 ADDRESS: 7/ 9 "--.E_ 1,4.)i.0 r,rA " lP,iD ADDRESS: y %U 2 I CITY,.STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# $T4 t Co L , 9761_6-T.6 CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: 7'z Y 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: BUILDING HEIGHT TO PEAK: / 7 i OCCUPANCY GROUP: 2ND FLOOR SQ FT: BUILDING DIMENSIONS: c, *Y.1"4/ CONSTRUCTION TYPE: UNFIN BASEMENT: NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT: NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE: 461 ('/ •-- FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: REAR SETBACK: CURRENT SEPTIC USE: LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: MANUFACTURED HOME SIGN I WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: IRELOCATION FIRE SAFETY PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE 1 PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP SPECIAL INSPECTIONS ® BOLTING ®CONCRETE 0 REINFORCEMENT ® WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: a COUNTY a CITY IS PUBLIC WATER AVAILABLE: YES NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES 0 NO IDATE: ' STAFF: METHOD OF PAYMENT: a ® 0 ® r r VISA CASH CHECK BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE. *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD I- /X g ett,. . . .. . . 24 .. y/17 9 DIC4•411Y' : . 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',. • t.-' : .; t ! ..,. ...;!. 1.,t_..,....;..i. 1 !...1;;.!, $ .:, I. " ,', ! ,.. t ! ' '. ' .!_,..._.;_..._ • ...„....;,,..;1....;...; , , $ ! . , . . t .. . , ! .. .. L... ; . !..s4+.! ! : : I ' !Ws •, : t .1 i ...._ • i , • . • - 16 , 5/7467 A,/ -60/. : ;.. . , '„, : : lei*"ir. • ' ,3 . —. .., A . ,jp. -.1 • -1 E. 41... dr 411 1e) '' • „ _ : ' , • t '....r..'t I...1. '...' ... ', ‘, ) 1 . ' , . h X ),6' aYle This site plan ' " i"'' "'9 submitted for the purpose of obfair incl a . ,l::- j permit and is a'true and uorra;ct r€ ,r'e$entaficn of he proposal. All known property lir esidimens ons, curb lines, structures and easements have br,nn id..ntified. Also indicated are wetlands, bodies of water, steep slopes or other p 'tics{ areas. l!'Si • aOUkE:S; ' • -1 _ 04 .UNE. j:t0A1.) WIDTH:..40 cRONT Hg ( HE.VIEV E[ BV C., i A �► r