2003, 09-25 Permit App: BLD-03-02594 Garage CITY doporeN, . , ,
.0,0Valley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIV/S/ON
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone:(509)688-0036 Fax:(509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: /2_ 1'4 i e1 �t 45/7et_ <j
ASSESSOR'S TAX PARCEL NUMBER(S): C'� g rd l'y
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
0 BUILDING PERMIT 0 CHANGE IN USE D GRADING a MANUFACTURED HOME
[RELOCATION El SIGN E TENANT ®OTHER
IOWNER / APPLICANT INFORMATION 1
® OWNER: Te 1'rtcl /Y1 0 APPLICANT:
PHONE: Pre-/ "15 iirJqCr 5F-AX: PHONE: FAX:
ADDRESS: /Z-er a 3 65 te-2/4 ...g ADDRESS:
CITY,STATE,ZIP CITY,STATE,ZIP
®CONTRACTOR: 8-4 re. (i# 6kG Ift 15 ® ARCHITECT:
PHONE: 2 2.-A f 'Z( FAX: /17 ' `f----` - PHONE: FAX:
ADDRESS: (V ? Z P-1( /CI
61(-Cjj A, 1r1 e1 ADDRESS:
CITY,STATE,ZIPL,,,Ae--� CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE# 5'WA'"? /9/14 ?L CONTACT:
IPERMIT/BUILDING INFORMATION i
COST OF PROJECT:i.7 2-" 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: t2-"'"'T'
BUILDING HEIGHT TO PEAK: /6 OCCUPANCY GROUP: 2ND FLOOR SQ FT: Flo
BUILDING DIMENSIONS: 9(VO CONSTRUCTION TYPE: $ P X-igrsfe- UNFIN BASEMENT: 20
NUMBER OF STORIES: Z STRUCTURES ON PROPERTY: FINISHED BASEMENT: /?1d
NUMBER of BEDROOMS: . CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK: '-
FRONT SETBACK: l r, "r CURRENT PROPERTY USE: DECK:
REAR SETBACK: 6l e- CURRENT SEPTIC USE:
LEFT SETBACK: lfl/ 4- CURRENT WELL USE:
RIGHT SETBACK: a f IMPERVIOUS SURFACE AREA:
IMANUFACTURED HOME SIGN
WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN:
YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN:
MANUFACTURER: TYPE OF SIGN:
I RELOCATION FIRE SAFETY
1
PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
PROPOSED USE: FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
1
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
I ,
SPECIAL INSPECTIONS
0 BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
I BUILDING STAFF USE ONLY
I
IS PUBLIC SEWER AVAILABLE: ® YES 0 NO IF YES: ® COUNTY ® CITY
IS PUBLIC WATER AVAILABLE: 0
YES 0 NO IF YES,WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: In YES ® NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES 0 NO PSSA: 0 YES 0 NO
IDATE: I STAFF: '
METHOD OF PAYMENT:
® 0 ® rte, 0 ""�'
CASH CHECK y. VISAi
BANKCARD#; EXPIRES: VIN#
AUTHORIZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
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140 x iZ
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Ind�A Qc
Building --�--
Planning I
Public Works —I--- /I
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Co
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/-' 1,0
SPEC (CATIONS /�'
IYPE OF SEWAGE SYS
•
J �• J,
LINEAL SQUAREOR TEM: V Z ;,`! 7
FOOTAGE //
TRENCH WIDTH: `��' °pjr0l/ASSyS
DEPTH FROM ORIGIN fJD S O�lO GST T
OF SEWAGE SYSTEM: IjRFACE TO BOTTOM • 0 c4! q6'C
OTHER: It i- N , STqIgT�'yF�F
SIGNATURE,
DATE___3/4i„2,7 .
r \ (60.00' -- -
,•
2D
( RESS: E. 12AA 3 Vie,\ Q.SLIj --
LI
�\, ZONE: --- 3. ------
J�% ROAD V DT'r:: �� xi5t,i�
C0'.I ENTS: 0 __ '�
40 out BUILDING —
9
��( E :'JIEWED BY:
O� LOCATION NOT ACCURATE
Po Yl
44 SF
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1
CF N TTeqC�S 14,0
VI
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FPNTRpFgnFCFs �CVFUyFA91�yIre' 0,•,-,01:?
A
o
500' 48.00' t' '' ' ' Zl_ 2-01 ,
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1326 50.FT.1 —FON.
RESIDENCE WALL
W. 7
.i., c______J_±__ ______.-----:_))
r: O
<-4 O
c <
1250 GAL.
TANK 0
V
160 LIEAR FEET6
DRAINFIELD AND
_ REPLACEMENT
10.00'w 10.00'
W
APPROVED ErrS
14( 160.00'
i
r/L11/411.-'17C7-(71::(
, �
fUr
SPEC (CATIONS l'A'°:14:0':°e;11;;Pi,k5')..,,,-
TRENCH
(YPE OF SEWAGE SYS OST,
TEM:// .
LINEAL ORS 'QUARE FOOTAGE: /i WIDTH:__.__ �/ ---DEPTH FROM ORIGINAL GROU JD S RFACE TO [SOTTO T�/ � q�
OF SEWAGE SYSTEM: �y�
OTHER: /I i_ sTq(gT0yF0�F'I
il
e'-'- Sc elU Oat/C "
SIGNATURE,
r
ILO.0,7 _____I
I 20.
ADDRESS: E. I 20 3 Vie-\le-5 __ ;
ZONE: ---- .5 ________
pz.ROAD WIDT:-M: (Po
OUT BUILDING (xi5+vg
FRONT: !CO FLAti;:::-: 40
b'-4
I
CC ;SENTS: 0c :-_ ___,,.,__________�
k:VIEWED BY:
LOCATION NOT ACCURATE
S.,
44 s
FAp::PIE ..'s/1$167JI)
��C�j B SSM�ST/GHT ONF A� � .�/�
4 �FP9 PFANEc SSR/C A,,F /4 ��
ryI/NF HA2Y
5 `
i/
(y ..
18.00' 1.00'
45.00' i.
132L 50. FT.1 FDN. 0
RESIDENCE{ WALL
W -,
e. 0
cv 1 O
VY
1150 GAL. I
TANK
1 I--
ILO LIEAR FEET (11
DRAINFIELD AND
_, REPLACEMENT
10.00'h 10.00'
w
APPROVED : ' • , . / 1
IL0.00'
M
r
N
160.00'
140.00,
WELLSLEY AVENUE
o to 20 _
712'm�
5 I5 40
SITE PLAN
SCALE: I" = 20.0'
LOCATION OF PROPERTY
E. 12903 WELLESLEY AVENUE
SPOKANE COUNTY, WASH.
APRIL 10, 1995
((REVISIONS BY IkN
DRAWN BY
CLINT 5EWRIGHT
DATE
APRIL 10, 1995
SCALE
- 20.00'
SHEET NO.
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O
two
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fv1
W
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OLO
cz
arks
((REVISIONS BY IkN
DRAWN BY
CLINT 5EWRIGHT
DATE
APRIL 10, 1995
SCALE
- 20.00'
SHEET NO.