2000, 05-23 Permit App: 00004127 Reroof 1.
I PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
iiii,
SPOKANE,WA 99260 SPoi CO Y 509-477-3675 44'' a---)
Project Description: ( (e - C o o± Y`. G wS -E
TYPE OF APPLICATION
Ig- Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other
SPECIFIC SITE INFORMATION
Street Address: g-3 1 4 z,
Assessor's Tax Parcel Number(s):
6 Legal Description:
Department Use Only
Water District/Purveyor: Sewer District/Purveyor Road width Setbacks
Front: > Rear:
School District: Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
12 Owner: Phone: S-34 3/p j Pt Applica Phone:144.1 ._7!&
C.ar ieA ri.. r. YN &S S Fax: -NIU 'v E\..11, riC.,Z Fax:
Mailing Address: Mailing Address:
—26// G c w l
City,State,Zip c___-_, City,State,Zig
Ci Contractor
Phone ❑ Architect/Engineer Phone
Fax Fax
Mailing address Mailing address
City,State Zip City,State Zip
WA State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor,ft. Unfinished basement sq.ft.
5 00 44--0 (-
Dimensions
Dimensions Total habit le space 2"d floor sq.ft. Finished basementt sq.ft.
�d
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
/`
Cost of projeci- Heat source(electric,gas,etc.)
7 ®0
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth_ Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
O Concrete O Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes O No What is the current property size?
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan O Yes ® No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?O Yes O No
O Don't know El Yes 12 No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan 0 Yes 0 No
O Maybe 0 Don't know O Yes El No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes O No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
O Yes No O Yes RI No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? El Yes ONo
O Yes O No
Is the property inside the ASA? O Yes O No Is public water available to the site? O Yes D No
O Yes O No
Is the property inside the PSSA? O Yes O No Is the property located within 1000 feet of a Natural Resource
Area? O Yes El No,
Date Received: Staff Representative: