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2004, 03-24 Permit App: BLD-04-03886 Garage BUILDING PERMIT APPLICATION WORKSHEET CIT\ City of Spokane Valley Community Development Department Jane Building Division 11707 E. Sprague Avenue, Suite 106 4000V ale Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: / /` j U 7 C -7--L) Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: ❑ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation n Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION Applicant: ❑ Owner: ��e.-r2,i _,. � o t��sc ), a. ,\ [I] pP Phone: I-6,,'6:,z Fax: Phone: Fax: Address: //,-(5•) 5 c 7-._. Address: -1'3 City State Zip Code City State Zip Code ❑ Contractor: /14.7 (c. , ,,, ❑ Architect: Phone: YC,?-o c t. Fax(1 La,')—/1. s'? Phone: Fax: Address: 63 5 z p FA..t�,� Address: Sp./1 c,.., w,A s 9 City State Zip Code City State Zip Code WA State Contractor License #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: #OF STO R IES: v x-3.)x-3.) MAIN FLOOR TO SQ. FTG: 2ND FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSJU9TION TYPE: HEAT SOURCE: o I. #OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OFROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC t(c.E 0 U SYSTEM? f \4' r\\0(\ 7\:) C'� MANUFACTURED HOME Width: Length: Year: Pit Set: Manufacturer: RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Phone: Fax: Address: City State Zip Inspector: Phone: Fax: Address: City State Zip SPECIAL INSPECTIONS ❑ BOLTING n CONCRETE ❑ REINFORCEMENT n WELDING Firm Name: Phone: Fax: Inspector(s): DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit,. re to the property owner. Print Name 2v)) `De►,--F) Signature t Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: site is being for the purer of PERMIT SITE PLAN obis planpermit and is a true and correct obtaining a building pe proposal. All known p�1I TY OF SPOKANE BUILDING SERVICES representation o the i f>�' res and easements havedimensiden curb lines.structures am weds, have been identified. Also o< otter criticalareas. P R O J N O: bodies ter'Sytre�p I ALLEY O R A/L � 4d y Dom. "; 7i4°i "? \ ADDRESS/1-492--L— '14—,.-W REAR ZONE ROAD WIDTH C.J2 KI. FRONT '( _..___.- COMMENTS01 REVIEWED B IrA VAIRO4 { A/L ) A L LEGAL DESCR: 3° I OR OR ��• 3.a ^. STREET HOU S_ STREET • OWNER: RESIDENTIAL FRONT COMMERCIAL \,, ig— JOB ADDRESS: 1 P/ 6 ? 5 9 7_-.