2000, 05-23 Permit App: 00004133 Remodelx-13
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11E1
SPOKANE COUNTY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING Sc CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description:
TYPE OF APPLICATION
'Building Permit
0 Change in Use
0 Grading
0 Manufactured Home Permit
0 Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: / ON (OZ (' _ t7 96, ���
�
Assessor's Tax Parcel Number(s):
Legal Description:
Department Use Only
Phone: !'J7j- �--^4�rfs�i
Fax: 53+ — 4543_
%�PPlicant: �j .�
" �_ — t) I
Water District/Purveyor:
Sewer District/Purveyor
Road width
Setbacks
Front: Rear:
Left: Right:
School District..
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
Owner: Phone:
0011/4 �r�- �%��.�(�j
r E>✓7'" s—„ t —
�✓ 20 �(`'eo
/ L.�f � ✓ "'G�/
# of stories
2 ---
�
Phone: !'J7j- �--^4�rfs�i
Fax: 53+ — 4543_
%�PPlicant: �j .�
" �_ — t) I
Mailing Address:
2"d floor sq. ft.
Finished basement sq. ft. , + _
Mailing Address:
/SoZ .
rh
City, State, Zip
Occupancy group
City, State, Zip
-—
r
-L—
contractor
Phone
< 4.4260W
'.c--�--Qcgt)
,534-- 4
0 Architect/Engineer
Phone
Fax
Mailing address
C`B oz_
;
Mailing address
Cit ate Zip
City, State Zip
WA State Contractor license #
4 t? k—i=}—
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
# of stories
2 ---
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Dimensions
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft. , + _
SI
, T
Occupancy group
Construction types
�'�i !/
Garage sq. ft.
Deck sq. ft.
Cost of proje
/ x 0
Heat source (electric, gas, etc.)
Manufactured Home
Sign
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation
Fire Safety
Firm Name
Previous address
Fire Sprinkler
Tent
Paint booth _ Fire Alarm
Fireworks display
Inspectors:
Is there evidence of fill or excavation on the property?
O Yes SNo
Proposed use
Value
Address
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property? ,
5 rhl '- 77!/// N"rc7 — 4-0-7-'
Phone
Will the site be served by a septic system? O_/Yes /' :No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
O Yes SNo
Are there slopes greater than 30% on the property? (3 ft rise in 100 ft)
( /%) O Yes No
Are critical or hazardous materials used or stored on st e?
O Yes No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? (Yes 1 J
If yes, identify on site plan )(?Fv— 74& i_, 4451, —
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identf on site plan O Yes No
What is the current use of this property? ,
5 rhl '- 77!/// N"rc7 — 4-0-7-'
Is your property in a designated wildlife habitat area?
O Don't know O Yes Wj' o
Will the site be served by a septic system? O_/Yes /' :No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
O Maybe O Don't know O Yes AsNo
Are or will there be wells located on the property?
If yes, identify on the site plan O Yes X.No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan O Yes
Is there evidence of fill or excavation on the property?
O Yes SNo
Are there slopes greater than 30% on the property? (3 ft rise in 100 ft)
( /%) O Yes No
Are critical or hazardous materials used or stored on st e?
O Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O ° Yes O No
Is public sewer available to the site? O Yes O No
Is' the property inside the ASA?
O Yes
O Yes
O No
O No
Is public water available to the site? 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 0 No
Date Received:
Staff Representative: