1986, 04-04 Permit App: 00010329 SidingUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner's Name (last) (first) (m)
Barge James W.
Department Use Only
Comm
2 Project Address (not Mailing Address) or Road Name Space Zip
E. 10306 Valleyway
3 City/Community
Spokane
State
Wn,
Wn ,
Subdivision/
_ �
Plat Name
PZ.1 J1
4Aprrill—
� FUV Parcel 2, 40�
Lot
Block
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act-. M
Zone
Project No. j nl
G
6 Dwell 0
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Bads -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Contractor Firm Name
McVay BrothersN,
Street Address
3106 .cronne
Zip
99212
City
Spokane _
State
Wn.
Phone
9(28-4)686
Contact Person
Harry McVay
License No.
MCV.AYBC 346ME
Phone if different than above
_ ( )
8 Owner/Agent (if different than S1 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
Plan Check (Y/N)
Other (Y/N)
SEPA Exempt (YIN)
Date
15 Type Work ❑ Bldg
❑ Fire
❑ MH
❑ Demo
❑ New
IX Add/ Alter
❑ Replace
E Move
❑ Other
14 Describe Work
Steel siding/ Soffit & Fascia
10 Applicant Name
1 Street Address
11 Zip
City
State
Phone
( )
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Additional Information
Valuation: $6315.00
Permit Fee: $9.0._00 4- LEO= = ctI.E-O
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
❑ Commercial;
❑ New Construction;
❑ Additional structure;
❑ Residential
❑ Bldg alteration/addition
Release
Release
w/cond 1
Hold 2
I
APPLICATION #
Conditions/Comments•
Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
N. 721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions/Comments.
Engineers:
N. 811 Jefferson ❑ Commercial; ❑ Residential; ❑ Flood Plain; I
O drainage 0 new access/approach; 0 fence;
O road improvements
Conditions/Comments'
Utilities:
N. 811 Jefferson
Conditions/ Comments•
Other:
co
c ❑
ro
a.
co
c
O
U '-
Es_ co
E
o
O
C
Plan Exam
Fire Prev.
Conditions /Comments •
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold