2003, 06-17 Permit App: BD-03-642 MHCity of
SPOKANE VALLEY
PERMIT #
BUILDING PERMIT APPLICATION
68g-oo.�
F,Ix b ff- o m 37
Box 1 OWNER JOB LOCATION ---1-Z37-5
OWNER'S ADDRESSLL-1.2-3 F l�u�l 16c� PHONE q22-4 ll) • Y
eL ft , L) iN ll
DESCRIBE JOB 0-71 Vaig - /� f2 C 12 ) ((p()')
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED P I< I a_ rra ►�
PARTNERSHIP CORP.
2
CONTRACTORS NAME PHONE
CONTRACTORS ADDRESS CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT P-{-r(p-1(i k Fataio_oe PHONE W.2 -q11
ADDRESS I Q E CITY (may"-.2e_3(\CcC.v'2S ZIP 2q0)(,
BOX 4 SEWER AVAILABILITY I\)0
WATER AVAILABILITY ES
B
5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER 0'7 y 0
LEGAL DESCRIPTION -vL! /CC_
(IFNECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) -poi- ✓_0eo5 1
CENSUS NUMBER LOT NUMBER 1
BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR / OTHER
BASEMENT UNFINISHED / DECK
1ST FLOOR /
/ BASEMENT FINISHED
/ GARAGE
2ND FLOOR /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING
FT.
BOX 8 ()) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS )
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE SQ. FT.
PLUMBING FIXTURES (Including rough -ins)
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BO) 10 Water Service meter size (if known) Also see BOX 4
11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO,FERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
DWNER / AGENT��
DATE G / % 02 CV -3 (OVER)
rhe epy authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard Expiration Date
Print the name of the Holder Signature
DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES.
OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL
REMARKS
DATE
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
PUBLIC WORKS DEPARTMENT APPROVAL
DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ =
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL
BY
ASSIGNED ADDRESS
Received
DATE
te
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AND R.O.S. BOOK 51, PAGE 46
FOR THE COMPLETE BOUNDARY
. AND CONTROL INFORMATION
,N S l 4,4.945:
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/ PARCEL "A"
3 ACRES +/--
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PARCEL
1 ACRE
169.20' 125.00'
N89.59'41'E
RIVERj'1'AY
SCALE= 1" = 80'
JAMES F. BES & ASSOCIATES
COMPLETE PROFESSIONAL LAND SURVEYING SERIN=
(509) 325-4529 (FAX) 325-4620
"B"
/-
5.80'
A
Jb/lb/ZIJtJJ Uts:7L
7G73L41JOi
Address/Legal Description:
Subdivision/Block/Lot:
JI\I 1/J LI IJ
FINAL AS -BUILT INSTJ4LLATION.
l q 17 E 1) -Ge. w rt ,y
Application #: Gid --O() 5 6 0
NORTH
1•
Note: The location of the on-site sewage system
represented by the drawing is not to be construed as an
exact locatio of th sy tem. 7 1
Remarks: l�L j (d I ('.;.,I/�
Partial Inspection )Sig ature:
Date: ( Ob
Final Inspection Signature:
Date:
nr C Ifs
Asbullt 6/2000
JUN 15 2003 08:52
Pump Chamber: gals.
Septic Tank Size: 1 DO C) gals.
Drainfield: 2.c _1 ft.
Leachbed: sq. ft.
Density is based on soil type:
Measured drawdown: in.
Residual head: ft.
Pump run time: min.
Pump off time: hr.
5093241567 PAGE.01
TF OF
( 11707 E. SPRAGUE, STE 106
valley SPOKANE VALLEY, WA 99206 ►
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMITTAL:
TRANSMITTAL DA'ZE:
PERMIT INFORMATION
t T517
Site Address: E
Parcel Number: 5-0N� f. O17 y
Subdivision:
Block:
Zoning:
Lot: PD
Water Dist:
Owner: (TCi f-tC.tic\ 'FCk r
Address: 3 T i U Cf L(
Building Inspector: K
BUILD
PLANNING: (2,U -k .K _ fi
s' 0
Permit Number: 10o3 -4gzissue Date:
Permit Use: S I f U ltd 'e M
Applicant - x
Phone:
Contact: pa fr et,
Phone:
012-111
Contractor:
Setbacks — Front., Left: Right: Rear: 1004'
APPROVALS
ENGINEERS: El( /,'"2
SEWER:
IRE IST= .
APPROVALS
JUN 15 2003 14:52 FR
11707 E. SPRAGUE, STE 106
° l ' WA 99206
SPOKANE
AX (509)688-0037
STT" INFORMATION
t? sr?
Site Address: I 5 E J
Parcel Number: S"sv7 0/ 7 le
Subdivision:
Block:
Zoning:
Owner: �C� 1�' t�4 r`ar�.
Address:
116142/3 Ttoerv,
Lot: (-:)
Water Dist:
Building Inspector: K
TO 3241567 r•el/Lu
PROJECT TRANSMITTAL.
TRANSMITTAL DATE:
- PERMIT INFORMATION
Permit Number: gpQ3 q Issue Date:
Permit Use: 6 jrti i -r ij►GQ.'f M • f ow e.,.
Applicant: x L 0 - M0.r
Contact:p 4tletc.
Contractor:
Setbacks - Front,
Phone:
Phone:
Right:5" Rear: 064,
PANNING:
ENGINEERS: E")C t3:
1ST