2004, 08-24 Permit App: BLD-04-07434 Finish Basement • N7L131L
BUILDING PERMIT APPLICATION WORKSHEET
CITYOF 01111111/\11111k
City of Spokane Valley Community Development Department
�� Building Division
Valle11707 E. Sprague Avenue, Suite 106
dooljj Spokane Valley, WA 99206
�] Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 18215 E. 10th Avenue
Assessor's Tax Parcel Number(s): 55194.0503
Legal Description: Turtle Creek 2"d Addition, Lot 3, Block 2
PERMIT DESCRIPTION: Finish Basement, roughed in with original construction
® Building Permit El Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement El Fire Safety El Other
OWNER/APPLICANT INFORMATION
® Owner: Layne and Ann Merritt ® Applicant: Owner
Phone: 927-0782 Fax: N/A Phone: Fax:
Address: 18215 E 10th Avenue Address:
City: Spokane Valley State: WA Zip: 99016 City: State: Zip:
❑ Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City: State: Zip: City: State: Zip:
WA State Contractor License#: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: N/A DIMENSIONS: N/A #OF STORIES: N/A
MAIN FLOOR TO SQ. FTG: N/A 2""FLOOR SQ. FTG: N/A UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: 352 GARAGE SQ. FTG: N/A DECK/COV. PATIO SQ. FTG: N/A
OCCUPANCY GROUP: N/A CONSTRUCTION TYPE: Wood HEAT SOURCE: Gas
Frame
#OF BEDROOMS: 1 in basement TOTAL HABITABLE SPACE: N/A IMPERVIOUS SURFACE AREA: N/A
COST OF PROJECT: 30%SLOPES ON PROPERTY: N/A SEWER OR ON-SITE SEPTIC
SYSTEM? Sewer
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 0 REINFORCEMENT ❑ 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 inure to the property owner.
Print Name Lyi 4erdz// Signat e v
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check 0 Mastercard 0 VISA 0 Other
Bankcard#: Expires: VIN#:
Authorized Signature: