2003, 04-10 Permit App: BD03-084 Garage City of
SPOKANE VALLEY
PERMIT # ��, -
BUILDING PERMIT APPLIC TION
Box 1 OWNER 57-c p c CUq Y1S JOB LOCATION f /3/Z /to 1'cti ford Ar
OWNER'S ADDRESS )3/2. 1) 7cAFo,JCITY licAltic PHONE ,.01—q3q 4w3
DESCRIBE JOB 3G1 X II/ PoLc La—ILA-14_5
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME 1UG ,�GaOS PHONE SVY 9Z&''-3iVr
CONTRACTOR'S ADDRESS 5 /3/Z //407C4 CITY V Gra„,4 lie
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT .74-'e e• b--1/4g PHONE Jn4' F39 zaey3
ADDRESS S /3/2 Nerd,Tv') CITY I.,crch/t Rigs ZIP 9803 7
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST$ /3J917. °'' EXISTING BLDG.VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR 1,1") ---19.g) 2ND FLOOR
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING 20 FT.
BOX 8 ()C) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
BOX 9 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.
BOX 10 Water Service meter size(if known) Also see BOX 4
BOX 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 PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT DATE y/O —"3 (OVER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa MastercardExpiration__ 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 DATE
REMARKS
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
DATE
ASSIGNED ADDRESS
Received
^iaTt c0
`:�p11707 E. SPRAGUE, STE 106
Valley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX(509)688-0037 PROJECT TRANSMITTAL:
TRANSMITTAL DATE: q1/1o/o3
SITE INFORMATION PERMIT INFORMATION
Site Address: 1-i J L S. 24-cA c9. Permit Number:0-;..0 W Issue Date: I10/03
Permit Use: L.
Liara yf._.
Parcel Number: 45'243.O LI Cr? Applicant: o '
Subdivision: (201` 'r.b r-cQ 4 U Trc,,c-±
Block: 14 Lot: 7 Phone:
Zoning:��7 Water Dist: Contact: 54-.€.0.R. t.Oct.
Owner: C. D S.f.'e 0.e.. , Phone:q Ligc13
Address: Contractor:
Building Inspector: K.e71 n mN r� Setbacks—Front.y+-Left:26'RightJj Rear:
6 APPROVALS
BUILDINGS: 1 4114044_7/Uht? `t'JJO .
c � ' O - 0 I22�
PLANNING: ,,, / l , -r../
/2
ENG .
ly_
HEALTH: D ic2th_ `C
D03
SEWER:
FIRE IST=
APPROVALS
WATER DIST:
STORMWA 'R:
OTHE
2 . 07
25•x'2
4,/love,
A-7,-) a / z.-/_ 4/
City of
SPOKANE VALLEY fpQ C� j
INSPECTION REOUEST4a/a 7-e. BUILDING DEPARTMENT
Date and time received V /0/03 .e„, (OD Permit Number y % •
Project Name
Site Address /3t Z J. ko c 7C(43/".C(Z.,
Requester's name 51-eL/ ej.V Phone number R 3 -' L{s-Li 3
BUILDING
Foundation Concrete slab Underfloor Framing Insulation
Wallboard Special Final
PLUMBING
Rough in Special Final
MECHANICAL
Rough in gas piping Furnace Appliances Special Final
SIGNS
Foundation Special Final
CLEARING AND/OR GRADING
Silt fence Erosion Control Special Clearing Final
OTHER
Foundation Framing Special
OTHER •
Inspection Requested for : Mon Tues Wed Th 41111 AM PM_
Comments
0 S ( % E PL-S\\ Q)Ck .
Inspector � Date &time inspected
S-VINSREQ
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