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2004, 07-14 Permit App: BLD-04-07065 Garage r r BUILDING PERMIT APPLICATION WORKSHEET CIT\t]F City of Spokane Valley Community Development Department polianeBuilding Division 11707 E. Sprague Avenue, Suite 106 4000Vale Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: N L l,005 c..r .� Assessor's Tax Parcel Number(s): L151 S / , /o /2- Legal Description: /� PERMIT DESCRIPTION: Pole- 1 L \A I -4'-0-s� Z1 Building Permit El Change in Use El Grading / ❑ Manufactured Home (I Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: I L; e; s 14---( El Applicant: Phone: /n-7372.- Fax: Phone: Fax: Address: ti?, /005- ‘5,,,,,,,,-(-- Address: 'Y V. 1)414-7C�'}, `7 Jam'I- ditytate Zip Code City State Zip Code 44 Contractor: toichi,r,.l re-ffe, ❑ Architect: Phone: 9j - /3c9 Fax: q - �'v7/f' Phone: Fax: Address: jd . 6 I Lf I Address: s© Lc�4 (Hz_i y Ci State Zip Code City State Zip Code WA State Contractor License #:�X t$$ 8 Contact: P� ( 7.0"-- PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: 17 DIMENSIONS.X�0 )( Ce---- #OF STORIES: / MAIN FLOOR TO Q. FTG: 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: '7p FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY G P: CON TR TIOIJ..TYPE: HEAT SOURCE: r U / , rr4'W-e_ #OF BEDFOOMS: - C TOTAL HABIT BLEFACE: IMPERVIOUS SURFACE AREA: 80 COST OF PROJECT: 30% SLOPE N PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? MANUFACTURED ROME 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 ❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT n 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 ❑ Check ❑ Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: K )1 -..... < . _______ - ikoPoSE/S it. ... I t .0.±_. 3/1.3,---'i—>' Exsi4n Howse. go:2 rfirte NJ --- rn Aletz 33x3t) aArd132- .0 .,-1(: ti --,... Li___ A ( p/51/" ---.„---- sweraimil ler the Wilms 04 ..> /- . This siis pion is being ADDRESSial)S-. •10 Sq77`‘144-- (< gi; ''., obtaining a building pante all 621 Ilue___Ind............1.00ffCt ''', tePteileetatiOn of the PIMPOIOW ow logurs lawl,""7 i IinesAlimensions,purl)tiras.11111100111110 and_111“ve=danti. ZONE ' -. dt ROAD WIDTH it- FRONT_____ i, - /1 habodiesve beoein wain:in:I:vibe:op. Ar ../ anientacii areas. . ' .' .•• signeilL__,_,,-, \ COMMENTS \ / REVIEWED BY ••(-0 Dote: • ' ".4( 4.• le- ) __ I 19-0p--*...yg etalciiie th'ms, .,,SAIre..r.t Re.. F:g. /COSA! SocleAt kJ-- 1