2000, 04-14 Permit App: 00002711 Addition 10cI PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
AlIlk
1026 WEST BROADWAY AVENUE
SPOKANE,WA 99260
SPOI IIS COINTY 509-477-3675
Project Description: c5 lic.4-4(G'e7C41
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TYPE OF APPLICATION
&Building Permit O Change in Use El Grading Cl Manufactured Home Permit
CI Relocation O Sign O Tenant (New/Change) O Other
SPECIFIC SITE INFORMATION
Street Address: it / /, �00e- ' yok/C�LLc..:, t qZ o�
Assessor's Tax Parcel Number(s): �°t/
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
0 Owner: / /� ]` Phone: /_, 7l/i, AAJpp/liccanntt: Phone: 3_7-7 6
R0 e 6A4 d12.4 O t"` Fax: vvv��� /' 6,, 0,/due_ 7,,,___Fax: q_IF- R-- 03
Mailing Address: Mailing Address: n
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City,State,Zip ` f p'' �J(� ry City,Stale,Zip
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yt, tactor I` ��/� Phone G;-�.'7L7`70? ❑Architect/Engineer Phone
t ►►► {p /t� l '- l 16a Fax 9.YJ -a �13 Fax
Mailing address ^ n Mailing address
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City,State Zip ' �/ L City,State Zip
7
WA State Contra tor license# Cont t name:
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.
1-216,
Occupancy group Con truction type Garage sq.ft. Deck sq.ft.
A .�. S-Qlakccsii
Cost of project; ec-
q b Heat source(e} ric,gas,etc.)
66l r ' � //�I /I- �-
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?
( /%) 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 O No
O Yes O No
Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes O No
O Yes O,No
Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource
Area? O Yes O`No
Date Received: Staff Representative:
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This site plan is being submitted for the purpose of l
obtaining a building permit and is a true and correct i`
representation of the proposal.All known property
2 S.� fines/dimensions,curb '• •,struct es and easements
_._ have been den ' Iso indicate6 are wetlan
bodies of :t; j slope o/ er critical ;,
/ .
signed: L i��►
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t Date:
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