2003, 04-23 Permit App: BD03-162 Garage City of
SPOKANE VALLEY
•
PERMIT # c
BUILDING PERMIT APPLICATION
Box 1 OWNER 6) rvtPiqv/s JOB LOCATION ( (p0 9 t
OWNER'S ADDRESS 000q E ytv CITY 9O HONE 7ro Fl�SO��
DESCRIBE JOB ( S-J- 04,u_„ earc ( y q
THIS PROPERTY IS OWNED B 401ffarrioARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME VVI.. S-e. 1 PHONE
CONTRACTOR'S ADDRESS CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERLIFIED)
BOX 3 CONTACT PERSON OF PROJECT PHONE
ADDRESS CITY ZIP
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST$ ��OO(� EXISTING BLDG.VALUATION$1(.55/-6b0 Hy"v�
BOX 6 PROPERTY TAX ACCOUNT NUMBER aI4 2.. (p(CLQ
LEGAL DESCRIPTION
X11 R�5 Pc-Ay � �rs2-mss
(2- - 13 6 -7 6,1W.
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER (jt
BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR
/ 2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ( ) SINGLE FAMILY .._ NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE ,5--7(00
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
— 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 Y KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PE -M T. ORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGE � �� 7 DATE 11 (z-3/o .3 (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
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
L
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 REC'D RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES : I AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS
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City of
SPOKANE VALLEY
INSPECTION REQUEST 64/'cz; BUILDING DEPARTMENT
Date and time received Li/2 t--1/0-5 a--' C5.57 Permit Numberj �
Project Name
Site Address (s LQ a tE.
Requester's name :TT-Din vl ct_v i S Phone number ?Co — 5 0 05—
BUILDING
y5BUILDING
Foundation Concrete slab Underfloor Framing Insulation
Wallboard Special Final
PLUMBING
Rough in Special Final
MECHANICAL
Rough in gas piping Furnace Appliances Special Final
SIGNS
Foundation Special Final
CLEARING AND/ OR GRADING
Silt fence Erosion Control Special Clearing Final
OTHER
Foundation Framing Special
OTHER_
Inspection Requested for : Mon Tues Wed Thurs Fri AM PM
Comments T 3 -3a
Inspector Date &time inspected
THIS BUILDING SBJ
ECTCTIONS
PECTION CUORRE
TOFIELptNsIONS
APPROVED BY � , 4, ,3
THESE PLANS MUST BE KEP
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