2003, 08-07 Permit App: BLD-03-02166 Addition •Ii .
.. one40,,Valky ('/C 460(7
IoERMIT APPLICATION WSHEE
rgc,,,,SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
i h 14, Spokane Valley, WA.99206. ..
Phone:(509)688-0036 Fax:(509)688-0037
RE `s D SITE INFORMATION
STREET ADDRESS: I V So/ Ezi` <)`
ASSESSOR'S TAX PARCEL NUMBER(S): 555?/• 05/5
,,FF,,50
LEGAL DISCRIPTION: C/
PERM ESCRIPTION: (Q 0 Li v l ,2 7z � aQ
5
BUILDING PERMIT C CHANGE IN USE C GRADING 0 MANUFACTURED HOME
QRELOCATION ®SIGN ®-TENANT [-OTHER
OWNER / APPLICANT INFORMATION
1
® OWNER: 'T Ow) I' �i[ 119'ev 1 0 APPLICANT:
PHONE: /"I 6^1143 FAX: PHONE: FAX:
ADDRESS: 1 r'SO S (i i ADDRESS:
CITY,STATE,ZIP_ 0 CITY,STATE,ZIP
®CONTRACTOR: G V 6 Al 4A/ Co-vi f G T"t ARCHITECT:
PHONE: G I ')-6 1-7 FAX: f 0 r/ PHONE: FAX:
ADDRESS: 31 1-/ G (Y411/if S7 /*ADDRESS: r
CITY,S ,ZIP eez/ 4( ITY,STATE,ZIP
WA ST CONTRACTOR LICENSE# G v(A/174-c_ l '7 CONTACT: � D 1
r
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 'c- 00° 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: 120
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT:
BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT:
NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: DECK:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MANUFACTURED HOME SIGN
WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN:
YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN:
MANUFACTURER: TYPE OF SIGN:
RELOCATION FIRE SAFETY
1
PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
PROPOSED USE: FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
I SPECIAL INSPECTIONS
BOLTING °CONCRETE ® REINFORCEMENT ® WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: 0 YES 0 NO IF YES: 0 COUNTY ® CITY
IS PUBLIC WATER AVAILABLE: ® YES ® NO IF YES,WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES 0 NO
DATE: I STAFF: I
METHOD OF PAYMENT:
® 0 0 r T0
Nk'tSt} 'f J VISA
CASH CHECK rwrm
BANKCARD#; EXPIRES: V/N#
AUTHORIZED SIGNATURE:
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
M
PV °,, n
0
ASS
30 Clu9 oo�
V.ke v.e,, I(lc
APPROVED BY(S Li a u •g17/os
APPROVED B
M oU 1q 9 Lf
06/07/2003 14:12 5093241567 SRHD EHS PAGE 01/01
.
FINAL AS-BUILT. INSTALLATION . ' c�4
•
. 141
i NOR C
Q. t •
y
r,1
1.
a9 ---- --- - _':r._� �____.._.-
•
•:1q‘-- -- -- -- -- - - '. .y ''''
i _- -- -
ti'i4r fl
Q4tt .i
y1`
REMARKS (Continued) • --------- - -------.-__../ 03--- _._ .a�?' _--___.-- .-_-__--.._.--.
,�
AUG 04 2003 14:13 5093241567 PAGE.01