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2000, 05-04 Permit App: 00003417 Reroof1111 SPoutCaIn -3`17 PROJECT APPLICATION SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 Project Description: - TYPE OF APPLICATION ZfBuilding Permit ❑ Change in Use 0 Grading 0 Manufactured Home Permit 0 Relocation 0 Sign 0 Tenant (New/Change) 0 Other SPECIFIC SITE INFORMATION Street Address: \ 7c L \ g ' \ \\2`C �A� \\"< x ( �C ��rACre Mailing Address: Assessors Tax Parcel Number(s): City, State Zip / �Y ��`c\, acY QS, \ l _ gR01 w City, State, Zip , 0 Contractor Phone Fax Legal Description: Phone Fax Mailing address Occupancy group Mailing address City, State Zip Garage sq. ft. City, State Zip MVOISR Da ment'd xi --- WA State Contractor license N QQ Contact name: tt x iter, b itnet(ltjiry r' ' i x .,•,a 2 Fri '>? 3' t Sewer qtrc[sF,irve a s �^ nny t s i J m: Rdad b{idth a d �' 3 x a Setti'ks r F°FE` - 16h" va r REr, Right: •- .. n , ••Sell➢°f1!%R� Icx: j Ftre D stock r a :., u a:. i .,optg ... OWNER/APPLICANT INFORMATION 0 Indicate who should be contacted regarding this project ow�wner. ` (\ .� \ Phone:�a t` 2_20 tcoo'� l.aJ �Qy W \\ 1 t�l�.s Fax: ctZ' - K7 \ l 0 Applicant: Phone: Fax: Mailing Address: `\�j lOL\\CL \ • `..1\\2K to aV Building height to peak Mailing Address: City, State Zip / �Y ��`c\, acY QS, \ l _ gR01 w City, State, Zip Dimensions 0 Contractor Phone Fax 0 Architect/Engineer Phone Fax Mailing address Occupancy group Mailing address City, State Zip Garage sq. ft. City, State Zip Cost of project_ � WA State Contractor license N QQ Contact name: PROJECT INFORMATION Building tnfoxmauon ` _ .. Building height to peak # of stories Main floor sq. ft. Unfinished basement sq. ft. Dimensions Total habitable space 2"^ floor sq. ft. Finished basement sq. ft. Occupancy group Construction type Garage sq. ft. Deck sq. ft. Cost of project_ � br QQ Heat source (electric, gas, etc.) Width: Length: What is the square footage of the sign face? How high is the sign? Year: Make: 1 of signs Area of existing signs Previous address Fire Sprinkler Paint booth Fire Alarm Tent Fireworks display Proposed use Value <. zf s yyt��� �ryq �� d x ati. sr e, ode Grsxn rice?. Firm Name Phone Is any part of The property within a 100 yr flood plain? If yes,identionsite plan 0 Maybe 0 Don't know 0 Yes 0 No Plans Examiner Phone Inspectors Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) (/%) 0 Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes 0 No Address f ju gp' a7 I$ I� he pro�q�t} nstc(etJ1 ,P ,SSA Inspector Phone 0 Concrete 0 Welding 0 Bolting 0 Reinforcement Address s ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Yes 0 No If yes, identify on site plan What is the current property size> (square feet or acres) Is any part of the property within 250 feet of a shoreline? Ifyes, identify on site plan 0 Yes 0 No What is the current use of this property? Is your property in a designated wildlife habitat area? O Don't know 0 Yes 0 No Will the site be served by a septic system? 0 Yes 0 No Is any part of The property within a 100 yr flood plain? If yes,identionsite plan 0 Maybe 0 Don't know 0 Yes 0 No Are or will there be wells located on the property? If yes, identify on the site plan 0 Yes 0 No Are There any wetlands, streams or ponds within 200 feet of the property? If yes, identify on site plan 0 Yes 0 No Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) (/%) 0 Yes 0 No Are critical or hazardous materials used or stored on site? 0 Yes 0 No DEPARTMENT USE ONLY IsYhe ppopeXt}{ to',de§tgnatedSco �'Ti:ubl n— ..: htroh# real 'Cr. I IR serve a az rt ` !S f X es x "4\1 Is tI e prb el ty.7Astc{e he:AS$? „ } yus s -', Q`' C ca es .c CV 4 a IS ppb)tc w tep ava labl� g t)}e5ltey o . f ju gp' a7 I$ I� he pro�q�t} nstc(etJ1 ,P ,SSA O; I gs ©N tea., . , .. Is th`eprgpe ty Iocaf@d uithjA �QQQ fei� , . . ..... ....,»..., . a N3tk els s fce Date Received: Staff Representative: