2003, 10-13 Permit App: BLD-03-02759 ShopOle
jvAk PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITYDEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, INA 99206
SITE INFORMATION
STREETADDRESS: /O'?Q Z E. giA 't V£
ASSESSOR'S TAX PARCEL NUMSER(S): YS Z/3. 6D
LEGAL DISCRIPTION: O /P7> 0L6 C/.
PERMIT
9BU LDING PERMTr - O CHANGE IN USE O GRADING ® MANUFACTURED ROME
![}RELOCATION [}SIGN [}TENANT QOTHER
OWNER/ APPLICANT INFORMATION
®OWNER: L/7 q �jL / ZWZl 0
PHONE: 3Y3 - z ZY3 FAX:
r/ m S
ADDRESS: IC 9�2 /-. D � XU -E
!� CITY,STTAA�TE, ZIP
❑CONTRACTOR: / 5-A'RE- .Cr'7`£ L_p r+Si.
PHONE: l' �G Y % pFAX: ZS%' SSY2
ADDRESS: AJX y / �'% �Z I���S CCJN
�
'` CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE M /C/F'✓'FCD�.3C %I
APPLICANT
AV Y'G" WE` -P/a
PHONE: / gL" SCc V> FAX:_
ADDRESS: STA
I CITY, STATE, ZIP
ARC ECT:
PHONE: YC/.3- (olg(FAX: /'
ADDRESS: 2%/3 C, l^/ l Lpu R i- S?J c4-'
CITY, 5 1 A I t, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COSTOFPROJECT: %/Oo
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS: 30K 2 V
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONTSETBACK:
REAR SETBACK:
30% SLOPES ON PROPERTY: ^4c�
OCCUPANCY GROUP:
CONSTRUCTION TYPE: 7U S
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT: '7?
2No FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT:-
GARAGE:-
COVERED
ASEMENT:GARAGE:COVERED DECK:
MANUFACTURED HOME SIGN
WIDTH: LENGTH: SO FT OF SIGN: HEIGHTOFSIGN:
YEAR: PIT SET: # OF SIGNS: AREA OF EXIST SIGN:
MANUFACTURER: TYPE OF SIGN:
RELOCATION FIRE SAFETY
PREVIOUS ADDRESS: - FIRE SPRINKLER: FIREALARM:
PAINTBOOTH: TENT:
PROPOSED
FIREWORKS DISPLAY:
BLASTING:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS
PHONE:
DATElFIME:
CITY, STATE, ZIP
13 BOLTING
13CONCRETE
0 REINFORCEMENT
13 WELDING
FIRM NAME:
PHnNF.
FAv.
8 BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: E3YES 13 NO IF YES: El COUNTY 0 CITY -
IS PUBLIC WATER AVAILABLE: O YES O NO IF YES, WHICH WATER DISTIIRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES E3 NO
IS THE PROPERTY LOCATED WITHIN ASA: [3 YES 0 NO PSSA: [3 YES E3 NO
0 0 0 o W
CASH CHECK
VIN#
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
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Pro 2Y�"
/YX
70
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