2004, 10-25 Permit App: BLD-04-08027 Pole Bldg FLB 12 2004 13:22 FR TO 108'?? 9? P.01/02
slaw
dowirValley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
. BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone:(509 36 Fair 309 9T
REQUIRED SITE INFORMATION •
•
STREET ADDRESS: '3M? e- , C C.7./ ./-6-, e .
ASSESSOR'S TAX PARCEL. NUMBER(S):
,: . .LEGAL DISCRIPTION:/e.9.0.0 te 1444/we,#fJ//24 -y iets-, me le 7 S 174
hi,�gA/ uc J/'QG:4t IA) .5. w. Qfr o J /(l.w. (pl.( a dill, 1r
PERMIT. ��.._ DESCRIPT • N.:
. I� EY =MIT ••CLOMP=-]N USE . Q GRADING •D NUMMI.'
NUMMI' ACTT RBD.ROME
,..DRELOCATION CI-SIGN aTENANT COMER-
..
t OWNER /APPLICANT INFORMATION
0 OWN /h/ / 17LO/75fA/ APPLICANT: Ct ' ' 6//?Z )--- `Z9
PHONE;`'SO9- :?(Q-ZokkgX: PHONE:2 { 777-7. 9lFAX:7. 4 . 57~goy76
ADDRESS: , i. , ; � -.vA/rA S Z3S ea// t, SPIi /
, ATe,x •rA , 4P
y 8-3^ `"/
aCONmACTOR:STeC/j/g-//lf9//tol /jfjVV.1 • ARCHITECT:
PHONEQB 777' 7. FAX:, K'4/,S7 J177O PHONE: FAX:
ADORES- - _ A I iii .1 A Al Z ADDRESS:.
CITY,.STATE.ZIb y CITY,STATE,ZIP
WA ST CONTRACTOR UCENSE# CONTACT:
rPERMIT/BUILDING INFORMATION
I
COST OF PROJECT:„ l3529 .- S0%SLOPES ON PROPERTY: ND MAIN FLOOR SQ FT: /
BUILDING HEIGHT TO PEAK: 1a_ OCCUPANCY GROUP;, I C.t.- 2"°FLOOR SQ FT:• /
BUILDING DIMENSIONS:9I/X1O CONSTRUCTION TYPE: UNFIN BASEMENT: / •
. NUMBER OF STORIES: STRUCTURES ON PROPERTY: ' / FINISHED BASEMENT: /
NUMBER of BEDROOMS: '' CRITICAL AREAS: V GARAGE: /
0f' ►FLANKING SETBACK: / CURRENX PROPERTY SIZE: Site PI COVERED DECK: i
FRONT SETBACK: / CURRENT PROPERTY USE '• DECK: )
REAR SETBACK: / CURRENT SEPTIC USE: 50 I C
LEFT SETBACK: / CURRENT WELL USE: i'.
RIGHT SETBACK: l IMPERVIOUS SURFACE AREA:
FEB 12 2004 13:18 FR TO 12087778597 P.01/02
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disoP Valley ,
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BU/LD/NG DIVISION
• ll707East Sprague Ave Ste 108
Spokane Valley, WA 99206
Phone:009 36 For 509 S7
REQUIRED SITE INFORMATION •
STREET ADDRESS: I?&T , cci�� �{�,i
ASSESSOR'S TAX PARCEL NUMBERS) �'7 /7/e , /O"7
'• . LEGAL DISCRIPTION: .�
PERMIT DESCRIPTION:
. 1: ULUDING•PERMIT DERA•GEZN VSE • CI GRADING •D.MANI1IFACTXIRED HOME
:;£IRELOcATION DSIGN 0 TENANT Cts -
1 OWNER I APPLICANT INFORMATION
11/01/2004 15:155093241567 SRHD EHS PAGE 02
. r . IL.14 1567-
00 0
81917 ' , ..:.:: SPOKANE 4,COUNTY ;-.HEALTH DISTRICT,
�,,.,, y,..E. O.'pLOEGER, .M P., M.P.H., HEALTH OFFICER.
F, l. L .. N.` Jef ... . . . .
'`Jefferson Street
t . ; . '» Spokane,'Washington 9201 y� 2
i DATE
PERMIT :NO. .. .2.L.,,,,. ..'../ O V `. ,
�--- . . No A 13170
,,b.. ,"`''-r".;PP ICATION''FOR' PERMIT. TO:`'INSTALL `.OR RECONSTRUCT SEWAGE`OISPOSAL FACILITIES
Name' V .4 Address / Pa f 07-0 Phone No, /i1 A C/-a S"`f 7
Address of Proposed'' tt,::.: Y, ;. . i .. .. . -
Type of Use : U r. • Is basement for building,planned? • '
Number of Bedrooms__' BuildingCapecity Camp Capacity ther
Water Supply / (CityWell, Spring). Drywall
Septic tank capac`lty ...,+. -,0/0"'0/0 8 n 0 s gals. Style of tank
Length of disposal field „ ,• /f v ��OO Absorption Pits _Leach Bed
{1) Shaw niltive.merlon et.;Propoee4 noose, septic lank, J��
disposal rlaid, wall. garage and,.othar.out hulldlnpa, �\
(2) Make note of any heavy nlopo on swampy etas or any ��
char Important tope raphtc detalla.
1 e 9i6 e
69 I
IP
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Installer6ir / f ! ' �I-z
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Final Inspection Date„�_yArei� :w4./
Rerrguksq\i /
/4ire d 4_ . a% /Z.f'I `
C' OR___ .1..;12421921,641Z---?
, a : 'a CY. MGAl.TH ! lu
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For Spokane Count/ Health District d
NOV 01 2004 15:19 509324156? PAGE.02
11/30/2004 10:31 5093241567 SRHD EHS PAGE 01/01
Appt."nine _..........._
STEEL STRUCTURES AMERICA, INC. Date
1 -860-833-9997 ''--------
1
Name 1- C. . k
Mailing Address \.39 2---? E _ 51/1044 ____. 14
city 5,0kiAState \Ai r., Zip_ .r;.12,1.ki
Job Address _. — , S .
City ________---State__ . 1 –Or-
Sidewall Gable
County _ _ Zip :
_____ —_.
Telephone Home Work -------- ' Building Size __x __. x
73-S •
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0 ____1.01_ 20' 30' 40' 59.), pi , 60' 70' 80' 90
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50' 1 , ZONE iu4.( ,5
V 1 il,,-..„ , • ROAD v40114,
COFRONT'FYI(J-- LANKING ,-- ri i
MMENTS i
.(: REVIEWED BY WM_ • 44. j
eoi • . c)‘) (2fi' i
•
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70' , This site plan itlIbeing submitted for the purpose of
..,-- - -1_ __ .,. _ I obtaining a • , •*, • permit and is a trim and correct
A representation • the proposal. All known property
lines/• . . ,curb lines.structures and easements
bodies iri4 • . Aid are wetlands,
, . , steep I
• other ,ritical areas.
-.
Dote: ll-?/0 -0 L I - 7
,
90' ,_51/1,(i,
f• :
- ign2s, -atureki Scale 3/4 = 10,
Customer Signature S--_( ,r
5093241567 PAGE.01
NOU 30 2004 10:36