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2003, 07-28 Permit App: BLD-03-02088 Storage Bldg .� Ht'N L11 c'.1::31:3.:514 �'r rK ` � i 11_1 .5,5403.0 F'.L1c2./ %-aa v SPOKANE VALLEY PERMIT# BUILDING PERMIT APPLICATION Box 1 OWNER Czar ScLeAkte JOB LOCATION sfacikLe,e ►fc.k kft OWNER'S ADDRESS 131..17 E. '-I"' CITY SPw g-e PHONE ebb-8 ' DESCRIBE JOB 2,1-l\..Y 30'X tv'b. post 5+(eP ...1ZuWenS THIS PROPERTY IS OWNED BMARRIED PARTNERSHIP COR.. s=sssa =asse=ssoaa-__--_asasas>lsas=es BOX 2 CONTRACTOR'S NAME i � ('6\3,4f), ;trite,3 PHONE Sol 5-3s ctdi6 CONTRACTOR'S ADDRESS S5/8 �, !i CITY /4c..--P Lf4 CONTRACTOR'S REG.# To wNc 2I 1.135,(• EXPIRATION DATE (9.-021 (CARD MUST BE PRESENTED AND COPED OR VERIFIED) ==,-7.=10===== sa=s=s--a----- sssrssa = a=sas11====re=- BOX 3 CONTACT PERSON OF PROJECT_"_1(1- t �,�dry PHONE 515-g0r ADDRESS CITY ZIP =====sssaszc �-•---• --�_ BOX 4 SEWER AVAILABILITY WATER AVAILABILITY_ ==ar=aasssass>s= as=ses=-•-----sass==sem ===s==ass :sans===== BOX 5 ESTIMATED PROJECT COST$ EXISTING BLDG.VALUATION$ sea acasaaasa>`___, z= as== =W--___s=ssssassasa --- - BOX a PROPERTY TAX ACCOUNT NUMBER `(.SSI • q 1 LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER ==zss=====..========aasauiner==ssr,=?.sassas wan==== -- a=s=ses = *-• BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR 1� / 2ND FLOOR / 3RD FLOOR I OTHER / BASEMENT FINISHED BASEMENT UNFINISHED /____ DECK / GARAGE 1 CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING I LI FT, =.___—'---======s======g 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. ss=ssme=_____ s ass=sem _. 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. _- _=a>a==s=sacs✓ _s =ss==========rice=sassrssss==tea= 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 e Street Use Permits for sewer,water,sidewalks,curb cuts.Contact the Public Works Department, I VERIFY UNDER THE PENAL •F PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF NOW EDG Nb FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PER •RM STH DF;I OR WHICH THE APPLICATION IS OWNER/AGENT ,y•- / DATE - (OVER) 1 hereby authorize the City of Spokane V tel cy to charge the fee for this permit to my credit card: -+ VL+a Mastercard --.� ---- --- Expiration Date _Print the name of the Holder Signature 1)41-.. Gr-rsr:1.7S-el-a::: ,Is ----- e 91-0(*sect f r ' 'S a( Meer 5 O V 4240' 140k d 7.---- . _ NI, G-0-4-e. l 'el,i's.A.0.4.6 vse,,Ke /coil iiiiiii \ ''' '''\7.. I 1 ----- - - . A 11 1 1 Se,....)C4- 6,r 9 A..PROVED BY_211,&---4-11.7 2- g'. ttS' Ill- f1 ' ,ave