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HomeMy WebLinkAbout2003, 06-06 Permit App: BD03-289 Finish Basement Cityof Ft b �8� c o -57 SPOKANE VALLEY PERMIT # Q3 ' 2 -(4( BUILDING PERMIT APPLICATION Box 1 OWNER(`_,\'Z\E 0_,i?1..0, — JOB LOCATION OWNER'S ADDRESS vim/ E, (-A CITY(,pte► cI 'ONE O2$ -1to-t I Loan DESCRIBE JOB Sln bot.s€xv,..ey-0- Coo ts THIS PROPERTY IS OWNED BY: SINGLE/MARRIED ✓ PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME C7� 9__ PHONE CONTRACTOR'S ADDRESS CITY CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT CSA-C2_‘ Y bf� PHONE (129i 1(01 I ADDRESS 1L 42 3cc\. l__c ar,2 CITY C- ? max- �;eS ZIP CnO l (o BOX 4 SEWER AVAILABILITY `•7\43, WATER AVAILABILITY t_114- BOX 5 ESTIMATED PROJECT COST$ `Siert, EXISTING BLDG.VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION _ CO 1,00 e.;(ft)) (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) Y q&-5� CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR / 2ND FLOOR 3RD FLOOR / OTHER / BASEMENT FINISHED / BASEMENT UNFINISHED 61.29/ DECK / GARAGE / CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT. BOX 8 (✓) SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT. ( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE_ SQ. FT. BOX 9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS,WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. BOX 10 Water Service meter size(if known) Also see BOX 4 BOX 11 Septic Tank-Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER/AGENT( -�e-3 DATE (o- to- 0"2, (OVER) I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercard Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. OFFICE USE ONLY-PLEASE DO NOT WRITE BELOW THIS LINE ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE TYPE OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER OCCUPANCY TYPE OF CONSTRUCTION STORIES BUILDING SQ. FT. @ = BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ TOTAL SQ. FT. TOTAL VALUATION BUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY DATE ASSIGNED ADDRESS Received `1 \ �� ~(` mO� �0\')°� _l / 7 | . ^/ `_ ' . _-_- _ > __--_ -__- . - _ , _-___-- - ___-_-� | /\ | | ~��_ --�� `�� { � -7� ` -7" L/ | \ L/ -�� / ` �� . ! � ! , �� ~� ( . " 8 ) - ` | � <� ` ' ^ /�U � � ,� U �o \-/ | � ' � » �� � | � /7 /' / ` ' �� \ > ' ^ —} / -. , �� ... ^ �� i | =~ . »m � | , I _ -- --— -- 4-fOD . • ' !! | . / / , | IF ` -� ' ` ` \ (| | t \ � / !| LlmO` - ' r |/4-6 | V � ^ �� | o \ .I ------- -------- - _ -_ - __-__ �l � �/ � _ ��\[«^�~~ 0Y °/ S =� ~w�~�p~• ' ' r 's, 4..: -.�/l `, ^ ���� �~ ~ / ~ \I _ 12 / / -1 ,(-A- --1- Vow gess r_ ulf- , x —pl. ,6102)-Le,,Th. Pt b a k . 1 /N f )r ; E ,............ 7 4-D -2A(.1 Eyed/6 ox-y-N X- 8 ,5) ; . c. \-2:1 :_. • i SMOKE ' OR / 4 . , SMOKE f 005. -4' DEFECTORJ �'� - D ,. 1 -dap 1