Loading...
2003, 06-20 Permit App: BD-03-659 AdditionCity of SPOKANE VALLEY ECEIIVED JUN 20 2003 Fill x g[tHtLiDrihq PERMIT #0 0.3 —?lvfq BUILDING PERMIT APPLICA ON 68g-oo3 ‘, co 57 Box 1 OWNED V&-uOE JOB LOCATION (2313 f 7.9"df-re--• OWNER'S ADDRESS CITY PHONE 53%5` T 75rff DESCRIBE JOB -- THIS PROPERTY IS OWNED BY: SINGLE/MARRIED 400 ar�/9 PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME CONTRACTOR'S ADDRESS CONTRACTOR'S REG.# PHONE CITY EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT1// %Xbifir PHONE ADDRESS 6-3/6-- Z CITY OkM)(ix_ ZIP 99rz2 3 BOX 4 SEWER AVAILABILITY w€42 (4k -(p C, O WATER AVAILABILITY ,C o BOX 5 ESTIMATED PROJECT COST $ 2 .�04 -� EXISTING BLDG. VALUATION $ '1 ,6-6)17 BOX 6 PROPERTY TAX ACCOUNT NUMBER i 5Z2Z„ /6335-- LEGAL DE RIPTION £//.�"p7 - La 301) FT otc$ %6_ o2,j V , � Ah 75 (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE ( isting / proposed) 1ST FLOOR 740, I / 9f.e 2ND FLOOR 3RD FLOOR / OTHER / BASEMENT FINISHED 4I47 / t.0 4, BASEMENT UNFINISHED / DECK CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT. / GARAGE / BOX 8 K) SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE ��� TOTAL AREA OF PROPERTY f SQ. FT. IMPERVIOUS SURFACE 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 MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES T �:,v FORM THE W.R FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT DATE ���03 (OVER) I hereby authorize the City of Spokane Valley to charge the fee tot this permit to my credit card: Visa Mastercard . Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. 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 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 TYPE OF CONSTRUCTION TORIES 3 OCCUP'NCY BUILDING SQ. FT. Z2 C(@ /t9<4, , = z o BUILDING SQ. FT. © = BUILDING SQ. FT. © = BUILDING SQ. FT. @ = Q¢TOTAL SQ. FT. TOTAL VALUATION BUILDING PERMIT NOL.003-3f/ PLAN CHECK FEE REC'D RECEIPT NUMBER PERMIT FEE /0 PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEE &441,0 WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES Received PROVAL ASSIGNED ADDRESS OUNT DUE DATE 1-).0--0_3 1' zP'"_ `p" `'e) CITY COPY JUN 2 0 2003 D �) M�`� (2 3/ Ci 7T-2/ /-iqoe THIS BUILDING SUBJECT TO FIELD INSPECTION CORRECTIONS .f/ C.Cr7 IL) /.4,-,r/ f)11 -P 2)(6-- ceicirtG -7/g0 • —(c 629(k Lt 32; e -e-; CITY OF SPOKANE VALLEY BUILDING DEPT. PERMIT NUMBER 6 D 1 3--'7&57 ADDRESS / 23 (3 Z. 7 - 4,e_ PLANS FOR h- -0-M oz- g,e OWNER 6)C1,;e- DATE SUBMITTED x APPROVED }0 APPROVED BY �'�