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2004, 02-02 Permit App: BLD-04-03483 Garage JAN 27 2004 16 22 FR TO 9245161 P.02/04 401,\144 .. . Srialuwe . ...OA/alley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11 TOT East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509/6884036 Fax15094)688003 r REQUIRED SITE INFORMATION ......,...........m...= Gj Z STREET ADDRESS: 6 14 -u 7 6 itv4 . 5Pd G� 1 'a 4'6. (�'rl ! 2 I ASSESSOR'S TAX PARCEL NUMBER(S): 3 5 /2. Y( - - D/p5 LEGALDISCRIPTION: / 0f3 Q5 - /8 Blbc� _b Cryt2c e:, ) 441...4:1-0;N PERMIT DESCRIPTION: ...5r0201-6- 2 u e " 3 J x Y 8 x t$' .121(WILDTNG PERU T DCHANGE IN USE OOGRAINING CIMANUFACTURED HOME DRELOCATION CISIGN CI TENANT 0OTEER OWNER / APPLICANT INFORMATION _....www.....n. 0 OWNER: 2 tA-L 4.,,.. I,-'k L.t t(2- CI APPLICANT: PHONE: 9 26 - 0/5 I FAX: PHONE: FAX: 2 N _ ADDRESS: 12 . OD J.)dIbI. - 51%00 t^4. //2-iADORESS: CITY,STATE,Z 44 IP CITY,STATE,ZIP 000NTRACTOR: _Seo tAdsi t Q r fro•00. ITN('• Pi ARCHITECT: PHONE 26 '0P ,S FAX: 911-,�l`/ J1,1„ i!ONE: FAX:__,_ ADDRESS: x--00` `L IL,J r 2'A Pit, !' ADDRESS: 5Pe k,,,nt 4 ok , iii 2 t t CITY,STATE,ZIP ' . ' �-n,`� CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# _Wok t 'F ** 14A " ' k C4NTACT: `� 12 I PERMIT/BUILDING INFORMATION COST OF PROJECT: 30%SLOPES ON PROPERTY: Pia MAIN FLOOR SQ FT: it Lf o BUILDING HEIGHT TO PEAK: 2 0# OCCUPANCY GROUP: 2ND FLOOR SQ FT: 'e- D k BUILDING DIMENSIONS:30X '18/15" CONSTRUCTION TYPE: [uY1 '-rios,S UNFIN BASEMENT: NUMBER OF STORIES: 1'-. STRUCTURES ON PROPERTY: 7__. FINISHED BASEMENT: -4-1.- NUMBER 1NUMBER of BEDROOMS: '� CRITICAL AREAS: GARAGE:6) FLANKING SETBACK: /01- CURRENT PROPERTY SIZE: 100 X027 COVERED DECK: 1''' FRONT SETBACK: ` CURRENT PROPERTY USE: AS' DECK: REAR SETBACK: I 0 CURRENT SEPTIC USE: - - LEFT SETBACK: //Q0 CURRENT WELL USE: RIGHT SETBACK; U 0 ' IMPERVIOUS SURFACE AREA; r JAN 27 2004 16 22 FR TO 9245161 P.03/04 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: FlemmiumimikRELOCATION FIRE SAFETY PREVIOUS ADDRESS:_, FIRE SPRINKLER:. FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY:,. BLASTING: DATE/TIME:- NimIllINIIIIMISIIIIIIIMEMMEEErne INA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: - PHONE: _ _. FAX: _ - ADDRESS:. - - - CITY,STATE,ZIP INSPECTOR: PHONE: FAX: - ADDRESS: _ ,_._ - CITY,STATE,ZIP memmiromemew r SPECIAL INSPECTIONS iimiiip.—irr1.1. 1.1171 ° BOLTING ©CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: _ INSPECTOR(S): ----- - 1 BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: 0 YES 0 NO IF YES: 0 COUNTY a CITY IS PUBLIC WATER AVAILABLE: 0 YES ® NO IF YES,WHICH WATER DISTIIRR: .. _ IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: O YES 0 NO DATE: STAF- ------------n-----wj F: METHOD OFPAYMEN7 0 ® 0 0 r _. ' ,41.1U4 rOtty i WM CASH CHECK L. ._ BANKCARD 0; EXPIRES.` VIN# AUTHORIZED S/QNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD cslf)._ rZ°, LL:a I' C �1, ` . c) — _ ---„- ----tet ! . - ,,,(c- °co \� . _/ •e--• -41fr Ge t' ,7- TrzoNs D (o-71 . C.o4-h_ ,wE - //c 4 i ."--c'(-PtNcr. toPs-. orizlz a .,9t 3s-i”--3005"&A- 15 ,-?y0 0 --- \---CLJ?:14)All j/r-( -------77-------\ N O �,c, � ) 31 * � � 1V . 4' 6 / -i i t Coo- AvE, APPROVED BY 4//, , ,, . e