2000, 06-29 Permit App: 00005542 Reroof I PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260 /l
SPOT( COUNTY 509-477-3675 61
Project Description:
TYPE OF APPLICATION
O Building Permit O Change in Use O Grading O Manufactured Home Permit
O Relocation O Sign O Tenant (New/Change) O Other
SPECIFIC SITE INFORMATION
Street Address: /a < F S '1,j-tsk't
Assessor's Tax Parcel Number(s): Y
Legal Description:
Department Ilse Only
Water District/Puveyor:. Sewer District/Purveyor Road width Setbacks
Front: Rear:
School District: Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
❑ Owner:
Phone: ❑Applicant: Phone:
Fax:
Fax:
Mailing Address: Mailing Address:
City,State,Zip City,State,Zip
Contractor Phone L{(, _ ef. ❑Architect/Engineer Phone
/°tGl�+s ci ltivhE'w i'�LoJ 3<- i Fax /4“S'•- Fax
Mailing address Mailing address
City,State Zip n ` ,
City,State Zip'55
� �l�l Ti �i11 �i�:a G,
WA tate Contractor license# Contact name:
I'hOUn T VLf3J?
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project `l Heat source(electric,gas,etc.)
�JLJ
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire.Safety
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete 0 Welding 0 Bolting 0 Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes 0 No What is the current property size?
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan 0 Yes 0 No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes 0 No
0 Don't know 0 Yes 0 No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan 0 Yes 0 No
0 Maybe O Don't know 0 Yes 0 No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes 0 No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( /%) O Yes 0 No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No
O Yes O No
Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes O No
O Yes: O No
Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource
Area? O Yes O No
Date Received: Staff Representative: