2000, 04-11 Permit App: 00002571 Reroofidc I
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PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
CO-- 257 I
SPECIFIC SITE INFORMATION
Street Address: l0_ /` f a / J / e r.5/
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: %! c roo rc GJ
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TYPE OF APPLICATION
[Building Permit
❑ Grading
❑ Manufactured Home Permit
0 Timber Harvest
❑ Relocation
0 Change in Use
0 Other
Cj State, ZipCi
OWNER/APPLICANT INFORMATION
Oywyn�er:
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/ J/ Phone: %� �
VI / 1-c.. Phone: y� �" ��/�
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V/7%�E✓ IL .j%/1ie'i/^ 1/�('j'Fax:
AlL' �i/!Se Fax:
Mailing Addre s:
1. 01 /l .
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I)) Ueis',s i f
Mailing Address:
6/I N. ‘.1; it c rs Vit/
Cj State, ZipCi
Slate, Zip
0 Contact:
-s 8 al
Phone:
4 a ha v ---Fax:
El Indicate who should be contacted regarding this project
I'llmc— Sp f / Kt k -----
Mailing Address:
City, State, Zip
Are there structures on the` property?
If yes, u�+ennfy.on site plan.
ADDITIONAL
ADDITIONAL INFORMATION
Is anyFpart of the property within 250 feet of a shoreline?
No
If yes ,ides ttfy on site plain 0 Yes
Is your property in a designated wildlife habitat aria?
❑Don't know 0 Yes No,',
Is' any part of the property within a 100 yr flood plain?
7f yes, identify on site plan
0 Maybe 0 Don't know 0 Yes No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan
0 Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ %) 0 Yes 0 No
What is the current property size?
(square feet or acres)
What is the current use of this property?
�denCa
Will the site be served by a septic system? 0 Yes yl No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes No
Is there evidence of fill or excavation on the property?
❑ Yes O No
Are critical or hazardous materials used or stored on site?
0 Yes 'LcNo
FOR STAFF
Is the property in a designated Stormwater Control Area?
O Yes O No
Is the property inside the ASA?
0'
Project Number:
USE ONLY
Is the property inside a Joint Planning Area?
What jurisdiction? O Yes O No
Is the property inside the PSSA?
O Yes O No
O Yes O No
Is public water available to the site? O Yes O No
Is public sewer available to the site?
O Yes 0 N
O Yes O No
Is the property located within 1000 feet of a Natural Resource
Area? O Yes O No
What is the zoning for the property?
School District:
Water District/Purveyor:
Fire District:
Sewer District/Purveyor:
Date Received:
Staff Representative:
Comments:
Sox CouKTY
•
PROJECT APPLICATION - Detail Information
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Number:
Contractor
Architect / Engineer
Contractor
Architect/Engineer
Phone
Fax
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
Building Information
Building height to ridge
# of stories / ,
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
rd floor sq. ft.
Finished basement sq. ft.
Construction group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
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:
Relocation
Fire Safety
Previous address
Paint booth
Fire Sprinkler
Tent
Fire Alarm
Fireworks display
Proposed use
Value