2004, 06-16 Permit App: BLD-04-04623 Garage BUILDING PERMIT APPLICATION WORKSHEET
0l'7 ioiane City of Spokane Valley Community Development Department
Building Division
a 11707 E. Sprague Avenue, Suite 106
.0001VleySpokane Valley, WA 99206
Phone: (509) 688-0036;Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 1 'g i (o E. 10 fk
Assessor's Tax Parcel Number(s): /-Fs3Li ' LHO
Legal Description:
PERMIT DESCRIPTION: ‘:ieciraf_,
ni. Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
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❑ Owner: -Fyn /rhor� ❑ Applicant:
Phone:(co) Z1{-Z83c(Fax: Phone: Fax:
Address: 14I8/ , r, !n Address:
Vero Ade_ WA- 671037
City State Zip Code City State Zip Code
❑ Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License#: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: 16,
6< DIMENSIONS: ,, / #OF STORIES:
t 2OXis �—
MAIN FLOOR TO SQ. FTG: 211,FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: 7O6 DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: .. coo 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
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 ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
I nspector(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 inure to the property owner.
Print Name /Jr /C ry,K Signature ')
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
El Cash ❑ Check 0 Mastercard ❑ VISA ❑ Other
Bankcard#: Expires: VIN#:
Authorized Signature:
/ II
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PROTECTION AND OPENINGS BETWEEN
DWELLING AND PRIVATE GARAGE$HALL WAVE:
,r 1)MATERIALS APPROVED FOR ONE HOUR FIRE RESISTIVE
LI
CONSTRUCTION ON THE GARAGE SIDE:
I—7 L R•TYPE•X•GYP BOARD(HABITABLE SPACE ABOVE)OR
J"----5-o - :' ' :-.;ivP BOARD tRESIDENCE/ATTIC,FLOOR/CEIUNG)
')f *SINGS BETWEEN GARAGE 1 RESIDENCE SE
e.gRatt
i';'1! I ;iObRS NOT LESS THAN I ,r'„• 20 HRE RIIIW
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1 OW ANQ PAIVATECN ENt\'� ` 3�gN O 5�8 TYpE 0 0r'• FIRERES1 :
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this silo plan is being submitted for the purpose;of
obtaining a building permit and is a true and�a ct
s
representation of the proposal. MI known y
lines/dimensions.curb lines.structures and e
have been identified. Also indicated are wetlands,
bodies slopes or other critical areas.
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