2000, 06-12 Permit App: 00004867 Reroof t t - PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
10 i SPOKANE,WA 99260 �r j
SPox COUI�I Y 509-477-3675
Project Description: i A JT } Q. ((tQ ALA
TYPE OF APPLICATION
L' uilding Permit O Change in Use O Grading Cl Manufactured Home Permit
O Relocation O Sign CI Tenant (New/Change) CI Other
SPECIFIC SITE INFORMATION
Street Address:/ /3 i //003,1/(4,_' c-,/1 to ? c
Assessor's Tax Parcel Number(s):` I l
Legal Description:
Department Use Only
Water District/Purveyor: Sewer District/Purveyor Road width Setbacks
Front: Rear:
School District: Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
Cl Owner: Phone: ❑ Applicant: Phone:
Fax: Fax:
Mailing Address: Mailing Address:
City,State,Zip City,State,Zip
gKontractor j! nPhone e7`D �x f ? ❑ Architect/Engineer
Phone
T3g11 _ aLS U//LICFax
Fax
Mailing address Mailing address
/I 3 W 5 c/
City,Stat t� uJ o /�-JC./l s (/l1 City,State Zip
WA State Contractor license/!// l Contact name:
(AMU U/O
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of project 5a5_
Heat source(electric,gas,etc.)
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face? ✓
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth_ Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No What is the current property size?
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan O Yes O No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes O No
O Don't know O Yes O No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan O Yes O No
O Maybe O Don't know O Yes O No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes O No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( — To) O Yes O No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes 0 No
0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
0 Yes 0 No
Is the,property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource
Area? 0 Yes 0No
Date Received: Staff Representative: