2003, 05-07 Permit App: BD03-361 Garage • ro
City of 62W 003 CP
SPOKANE VALLEY firn0037
PERMIT #
BUILDING PERMIT APPLICATION
Box 1 OWNER J R�Q+ j • JOB LOCATION I(f?\.5. ( ,
OWNER'S ADDRBSri
CITY PHONE or
DESCRIBE JOB G ► 6
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME/VA , ret_. PHONE -I` ) 010(4)CONTRACTOR'S ADDRESS! 45O 6 CITY
CONTRACTOR'S REG.# / F w� c) / t) EXPIRATION DATE2 0,33
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT 7.tv 14'00 Nb PHONE 4 qe.7`' !o(,
ADDRESS S525 ov
tet. CITYS�o f.e," , ZIP �5, 'y.t
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST$ 9 06vat.,.$ EXISTING BLDG. VALUATION$
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR / 2'.( 2ND FLOOR /
3RD FLOOR / 1I
OTHER /? / /rdr BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ( SINGLE FAMILY ( ✓1NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE_ ! SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS,WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size(if known) Also see BOX 4
BOX 11 Septic Tank—Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES T PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT tit tiri IetotO DATE J" 2-7 t>c>
(OVER)
r +
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard __ ____ Expiration Date
Print the name of the Holder Signature
•
OFFICE USE ONLY- PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES I AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS
"icrr 6.
o ne 11707 E. SPRAGUE, STE 106
Valley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX(509)688-0037 PROJECT TRANSMI1'IAL:
TRANSMITTAL DAIE: 5-_-7_03
SITE INFORMATION PERMIT INFORMATION
Site Address: '(y c f 2-5` E. J q t(`t'y tua y Permit Number:op o3-3 41 Issue Date:5'f 7/ )
Permit Use: 24 X 24 E&rc5 e eater .
w 12_ Xg �j
PS'
Parcel Number: Li 5 /3 4/. old 2„ App icant: M . (
Subdivision: s P - 91(, _ 9 3 1
Block: Q Lot: Phone:
Zoning: Water Dist: Contact:2o4,1 ML ba,,,,,.(Q
Owner: J;e f r tt, Phone: 4{j7..0 i 0(e
Address: f 64? E Uar/ Contractor:
Building Inspector: gosr,..6 N. Setbacks—Front: 7 - Left: Right:i/ Rear: 7'
APPROVALS
BUILDINGS: Gs.- --)er,..„,,Ii..,GejA ,6"/7/0_3,
PLANNING: 7/1 1 '/fl t/ L ftO 5/71Jy._ 7` 'e
'`
ENG ERS: Ct 'J.�211.crC 0-. L
7
k n `�� /,(,l�. L �C�-L-,/ q 5/3/61 3
HEALTH:
fan CJ`
SEWS :
DIST;
APPROVALS
WATER DIST:
STORMWATER:
OTHER:
00
X2. 1
02o6l• 2�
t O.
. . . . . .
aaa •.2 `
05/07/2003 16:11 ___ 5093241567 SRHD EHS PAGE 01/01
TO 3241567 P.01/01
85/07/2003 13:59 51.14 415b/ MKMO MMM rMuc uii.
I
•:( • .•
FINAL,AS-BUILT JNSTIL AT1ON
i. roes/Legal Desr�iption: , / 4/2 5 i W(t ,
. .
••.r. 8ubdiv tonn3loa ut , .........
-
pplicatlon#: T s'-oll 98
APPROVED :' col ' NORTH '
v • •
1
g� ` 4At e�
t Po
' 0
' z9'--ter . --r- -`2 7.1'."''t �(aa/ ��'
I I 1
1
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ILijd .....--5 17-
e .1.s
1 171 .,
I �►iii'.,.T.,,
1 4 2314
iv 12:
A, , S /
Note: The location of the on-elle sewage system'represented by th 7•;1 -wit G '
construed as an exact location of the sys{em, n Is no to.be
Remarks: (�
Eze: loo O gals. .
2 ft.
Sinat �q. ft.
9 ure: / �;'/Oate: / -� }a 6 ."' d on soil type: r
ng: 0 Yes No
z
r
** TOTAL PAGE.01 **
MAY 04 2003 16: 10 5093241567 PAGE.01
A 11,
THESE PLANS MUST BE KEPT
ON THE JOB SITE THIS BUILDING.SUBJECT
TO.FIELD INSPECTION CORRECTIONS
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