2003, 06-03 Permit App: BD03-236 Garage Addition ;ity of IoW-003(0
POKANE VALLEY f)e (D ri(-Oo37
PERMIT # (3 P 03-231.e I
B I DING PERMIT APPLICATION `
ox.1 OWNER •
•
?
/� N 4I c JOB LOCATION (
OWNER'S ADDRIFSS CITY PHONE •
DESCRIBE JOB /`Y27 (G` /f �.
ax ./ Ga )4 '1' ,n,
THIS PROPERTY IS OWNED :y:SINGLE/MARRIED
PARTNERSHIP CI RP. • •
DX 2 CONTRACTOR'S NAME
Ad - 01,4,4.-a PHONE kiC•2 6/04
CONTRACTOR'S ADDRESS U S 2.S /V r - _ • CITY �. J `t'&f- -
CONTRACTOR'S REG.# g w._ c6 Icl 2 /?n EXPIRATION DATE 6 — k(i- 2 Cd
(CARD MUST BE PRESENTED AND COPIED OR VEFFIED)
)X 3 CONTACT PERSON OF PROJECT pc,A, m C, ONS`1 PHONE 6/6.2- eves co
ADDRESS CITY ZIP
---------------=- -------------------------
)X 4 SEWER AVAILABILITY ----
WATER AVAILABILITY
f
)X 5 ESTIMATED PROJECT COST$ Sc,(Jo, 0 J EXISTING BLDG.VALUATION$ • I
X 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
I
•
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
I
• CENSUS NUMBER LOT NUMBER
K 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR Lao / 2ND FLOOR • / •
3RD FLOOR / OTHER _/ BASEMENT FINISHED /
26
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT I TO L / HEIGHT TO PEAK OF BUILDING ,1
--- � FT. .
8 ()C) SINGLE FAMILY ( ) NEW CONSTRUCTION -
C ) MULTIFAMILY(NO. OF UN TS ) . ( ) EXISTING STRUCTURE
( ). COMMERCIAL/INDUSTRI L TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE— II• .
:9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED P UMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR U ITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, B CK FLOW PREVENTERS, ET AL:
10 Water Service meter size 'f known) Also see BOX 4
11 Septic Tank-Not generall, allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and t e Health District (See BOX 4)
12 Street use may require a" .treet Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
',IFY UNDER THE PENALTY OF PE-JURY THAT THE INFORMATION FURNISHED BY ME IS TRl'JE AND •
ZECT TO THE BEST OF MY KNOW EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
/E PREMISES TO PERFORM THE ORK FOR WHICH THE APPLICATION IS MADE.
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-PLEASED — ---
______________________________________ ASE__O NOT WRITE BELOW THIS LINE===========================_-- ---_--___—_
ZONE SETBlACKS:' FRONT — ---___
SIDE REAR
HEIGHT LIMIT______._
PLANNING DEPARTMENT APPROVAL
DISAPPROVAL
REMARKS DATE
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENIIAPPROVAL
f ' DISAPPROVAL
REMARKS DATE
PUBLIC WORKS DEPRRTMENT APPROVAL ====DISAPPROVAL
DISAPPROVAL
----------------------- DATE
TYPE OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL
NEW COMMERCIAL• ' , IND.ADD/ALT
COMM.ALT/ADD NEW MULTIFAMILY
NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP.
ROOF OTHER
OCCUPANCY i TYPE OF CONSTRUCTION
• STORIES
!___BUILDING SQ. FT.
BUILDING SQ. FT. @ •
BUILDING SQ. FT. @ —
BUILDING SQ. FT. • @ —
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT Np. • PLAN.CHECK FEE RECD
•' RECEIPT NUMBER
'i
PERMIT FEE
•PLAN CHECK FEE PLUMBING FEE
MECH. FEE
TOTAL FEES= _WSBCC SURCHARGE
ENERGY SURCHARGE •
OTHER CHARGES
AMOUNT DUE
BUILDING DEPARTM, NT APPROVAL . 'BY
DATE •
ASSIGNED ADDRESS
I I , �
• "-0
06/03/2993 16:37 93241567 SRHD EHS PAGE 91/91
-- -- -- TO 3241567 P.01,02
56
•
I •
•
• I
4poi (VW003
f
QXrANmVALLEY •
p�T# Fav � -bo3'7
BI,TILDING PARMT APPLICATION
rl OWNER WASta LJOB L'OCAITON •
OWNER'S AD SCITY . PHONE
DESCRIBE JOB AY2? E (4./I LA.' I .
+r /V .
"illi . . . wiiIIIII
THIS PROPERTY IS OWNED EY:SINGLE/MARRIED
PARTNERSHIP
-�_a CORP,______ /
:2 CONTRACTORS NAME �( �� NE '® " •"" (//
F!HON a/off
CONTRACTOR'S ADDRESS S JV f4v a_ Crry $$04 / 4.♦'.m_ _- I ii 3
CONTRACTOR'S REG.#r; G 7 1
(��z 4''7 EXPIRATION;DATE G— J 2 adi'1
' _�,.___ (CARD MUST BE PRESENTED AND COPIED OR VE•IFIED)
3 CONTACT PERSON OF PROJECT c- ON �� PHONE . --
Al'
a/C2
ADDRESS CLQ, I
4 SEWER AVAILABILITY
WATER AVAILABILITY
5 ESTIMATED PROJECT COST •—� 0, (___0___ EXISTING BLDG.VALUATION$
•
6 PROPERTY TAX ACCOUNT N MBER '
LEGAL DESCRIPTION
•
(IF NECESSARY,PLEASE SUB ITA SEPARATE PAGE WITH THE LEGAL DESCRIPTION) r ,
CENSUS NUMBER L• NUMBER`S I •
BUILDING SQUARE FOOTAGE•Ex-Idris/proposed) 1ST FLOOR 143 1. 2ND FLQOR ' /
3RD FLOOR / OTHER_J BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE '
. ..- ... . . . .. . .
CARPORT / / ...
: TO ' , HEIGHT TO PEAK OF BUILDING • FT. .
) SINGLE FAMILY
(` ) MULTIFAMILY(NO.OF UN TS ( ) NEW CONSTRUCTION
('
( ) COMMERCIAL/ RI•L ) • ( ) EXISTING STRUCTURE
( ) TENANT IMPROVEMENT TOTAL AREA OF PROPERTY SQ.FT.
• IMPERVIOUS SURFACE ?. SQ FT. •
PLUMBING FIXTURES(Including rou - _
) .,MECHANI APPLIANCES '
PLEASE USE THE ATTACHED P UMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS,HEATING AND AIR U ITS,FIREPLACE INSERTS,WATER HEATERS,CONVERSION BURNERS,
LAWSPRINKLER SYSTEMS,B•CK FLOW PREVENTERS,ETOL: .
Water GB'rimier sae rt known) Also see B 4
Septic Tank-Not genera allowed in the City of Spokane Valley.For s eoiel cb cumeta '
Your sewer purveyor and t a Health District (See BOX 4) ncea contact
Street use may require a'-Creat Use Permit*for sewer,water,sidewalks,curt)Gut. •
Contact the Public
Works Department.
•
UNDER THE PENALTY OF PE- URY THAT THE INFORMATION FURNISHED BY ME IS TRJy1E AND'
T TO THE BEST OF MY KNO 6 GE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
'REMISES TO PERFORM THE ORK FOR WHICH Twp 6 ow If.ferk#11,1 IC.IAP
MAY 31 2003 16 36 5993241567 PAGE.91
'ERMIT SITE PLAN
'ROJECT NO.: A�,<t'
egal Description: � REAR
APPROVED BY _ _ ./! _,_ _-_ o4
/({(/0
)caner:Vv �
� �.,.j o v) & d ex l s-1-1,,..,\
IL A/I'
residential A 1 OR
OR STREET
;ommercial . STREET
ence Certificate Required? HOUSE
YES NO
•
)eveloper Services:
/
',oning: Property FRONT
Line
,;ITE ADDRESS: \------ ---ir
. / Of :2,7 r VA iv',"
i VTUDY(
•
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