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2003, 09-17 Permit App: BLD-03-02499 MH CnraF e‘11114, .00Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS:_/1OoS 4"- a';it .��5 % i 1��d9.r/� Y 4/l GD i* 9 e9,---26'ASSESSOR'S TAX PARCEL NUMBER(S): %©/07 / LEGAL DISCRIPTION: s0 tie,D I/7 ��' 77/E /4/;,-//97/4- df i�'{�cf //yea o/!/�0�/�O e ff' /e ,4 % 7� �5Coir �'G e,e6 e6 l Al f'D/U/J r `�i' or /44975, , /J GF e ,7 Q PERMIT DESCRIPTION: /004'/.4.E /-742,296- ,6e./.0z 4"7- 0 u i0 BUILDING PERMIT 0 CHANGE IN USE 0 GRADING 0 MANUFACTURED HOME RELOCATION D SIGN Q TENANT ®OTHER OWNER / APPLICANT INFORMATION ® OWNERZ441.40—,VCE' f c-✓i6 7 Wi4.7?,QI)4 ® APPLICANT: PHONE: 9Laca 17570 FAX: PHONE: FAX: ADDRESS:I/be IJ/. 6/4/i/e/Is e 7[� - b.ff lir- ADDRESS: V A)-11€y et'f �i 9ao6 CIfY,STATE,ZIP CITY,STATE,ZIP /jPfr.� r p tY-'t>�t ✓:.'.1. ARCHITECT.: CONTRACTOR:M/%A PHONE: 0 " 6 1E'c`f FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# CONTACT: I - PERMIT/BUILDING INFORMATION COST OF PROJE y d� 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: / 2ND FLOOR SQ FT: BUILDING DIMENSIONS://X 2.0 CONSTRUCTION TYPE: UNFIN BASEMENT: -- NUMBER OF STORIES: / STRUCTURES ON PROPERTY: I FINISHED BASEMENT: NUMBER of BEDROOMS: CRITICAL AREAS: / ' \ GARAGE: FLANKING SETBACK: CURRENT PROPERTY SIZE: I Ci(T Y., COVERED DECK: FRONT SETBACK: I CURRENT PROPERTY USE: 5 DECK: REAR SETBACK: 'pC_`� CURRENT SEPTIC USE: -"F , L- LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: L' IMPERVIOUS SURFACE MANUFACTURED HOME SIGN i WIDTH: /1 / LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: (6.-- PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: IAS/71.04 TYPE OF SIGN: IRELOCATION FIRE SAFETY i PREVIOUS ADDRESS: 'iA-.6-C. eL)e FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: Q g, e/ Isy'T FIREWORKS DISPLAY: WE LAi /c. BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE I PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP SPECIAL INSPECTIONS 0 BOLTING °CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: 0 YES 0 NO IF YES: 0 COUNTY ® CITY IS PUBLIC WATER AVAILABLE: YES NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: 0 YES 0 NO IDATE: ' STAFF: ! METHOD OF PAYMENT: ® 0 ® r VISA CASH CHECK _ exammo BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE. *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD I LOT B I :1 3,645 I SI• ; 42L„ ,, . .4\ N peaPc 6 1��-��'-,uf f..ar140'.ai}:�1 y int D1 I !O EXAMINED k� 2 ,,,t N89.33'3f"E ' 311.42' isly .. 174.94' . .. 136.48' N Ca'Q HOT TUB—' f �� .S4.7q ...t :.\„sse'‘ AV AEI 43AO m.o. ,'� BLDG w d - • G; ,.''dif1� - `, tc LOT o c�r LOT o.- o o \ A o �' B �o , 'p`� a o o N1002 UNIVERSITY RD cp o ' Mc8"�-- �� ��' `; r o HOUSE SPOKANE, WA 99206 v, '- EXAMINED - C 32.40' t\, 43.40' N.) x•� 1,4 �.•:'':• . :•: CAR : GARAGE:p..4' �. .1 N S89.33'34"W : • ::„.,.............:,•!:-.... ...,• i;;_•': PORT o 64.40' o �1 ! o �' / 174.94' -IQ89'33'34"E 136.8' o: C A L TA D 0 AVE ' \CURB DROP ( •. 14$9'5 'E, 480.42' 157' TO CL OF VAN MATER RP POWER POLE - DETAIL ::: .. 1: > \BACK OF SIDEWALK . SCALE: 1"=50' -, "a - _=:: •'.. Jndiana . tlome _ . /� scams Ll �O ••¢ . . tw'rte ^rte=_..•. -L~2=mak.L:_--- .1 Noce m Is3.:.N.1 t. .'•• _: - - < _• THIS MAP CC -�,s �� �m '_ •Nord � y�tt.�••.;��,•��'�:' .: ° � :�� �t DIRECTION I 1 C` �• ,Mission . . .:*.• ,�.;. 4.,y,,., a . • COUN y� Iii t Haut w.--...... .��'j .. ••.: 't' •••••••• .� .Mtiaxwetl' ..;_it;.. y� �f. �' .. _. 1-,--:—•--.9. :-,•,•; :�.i silo w F, t y. L 1 / Cir,.:, �t!i �� 33 .5 10 (S'''Ir.d.°' ' 1. I • _ • - ` /5,... . Y` - C ':•:...:'.. ,,, ; .^^;•' I td`.Ml •t>+- 9000e Av.. Z m R'I HT1 / ', °^ 0......::= t7esmet. • ��D ELS n TA—GG :� . : ...X c.taWDAv:J • m m< -7 e tie`s , .. •.''ioo. _ : -:, ••, . : `-.: 1 ® „ r_ o m / -800-•37-3074 cl ~ ��” +� ! 6roadwa...M 2 CO me w % is, -�. r or. -o :field ;Q>• _ rSPrngGe •:t m .� .. .- AlidA.0 siv. �rA �{ NO. SHEET NO. 'm' m •¢ , �~�• " 3 m . i- 0'� • - LR 1 OF 1 VICINITY MAP cn: m WY; NW f •