Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2005, 06-03 Permit App: 05001950 Addition Garage
Spokane 40,00 Valle BUILDING PERMIT APPLICATION WORKSHEET ok ne Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 JUN U 3 20G5 Spokane Valley, WA 99206 infIN hone: (509) 688-0036; Fax: (509) 688-0037 REQUIRE p SITE INFORMATION Street Address: 4)34- .5 op P4 Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: I 6AM ® Building Permit ❑ Relocation P,J ki -,t; ALIJ-1-1* n Change in Use ❑ Grading ❑ Tenant Improvement ❑ Fire Safety n Manufactured Home n Other OWNER/APPLICANT INFORMATION El Phone: 34-`7 Fax: Ad ress: #3 5 Jo3GL %City State 1,..,.). VContractor: Owner: 0A`>> o► L II Id Applicant: Phone: Fax: Address: Zip Code City Phone: Fax: Address: ❑ Architect: State Zip Code Phone: Fax: Address: City State Zip Code City State Zip Code WA State Contractor License #: Contact: Spokane Valley Bus. Liscense #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: 17 - DIMENSIONS: 1 `` i I,O `1 # OF STORIES: MAIN FLOOR TO SQ. FTG: 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG:5-50DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE 1 HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: oP ©� 30% SLOPES ON PROPERTY: LSEEWER R ON-SITE SEPTIC SYSTEM? MANUFACTURED HOME Width: Manufacturer: Length: 'Year: Pit Set: RELOCATION Previous Address: Proposed Use: FIRE SAFETY 1 Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Valuation: Above/Underground. Storage Tank Size: r Date/Time: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Phone: Fax: Inspector. Address: City State Phone: Fax: Zip City State Zip SPECIAL INSPECTIONS ❑ BOLTING Firm Name: 0 CONCRETE ❑ REINFORCEMENT Phone: Inspector(s): Fax: ❑ WELDING DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, cod: s or . rdinances. Ownership of resulting development rights granted by any issue Print Name (c -fl (SI a L 114 Signature ermit inure the . ope y owne Method of Payment: (Faxed permit applications gill only be accepted with major bankcard) ❑ Cash 0 Check Bankcard #: Authorized Signature: 0 Mastercard ❑ VISA ❑ Other Expires: VIN#: �0ci( / • + i2,J � _.._ S ti"/492).1)/'Tien) SOLA �1G /c�� T CCNr2 _Col r oc 11 /0S 4-100 -0 4,_ LzI