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2004, 03-19 Permit App: BLD-04-03817 Pole Bldg BUILDING PERMIT APPLICATION WORKSHEET riCIT\ '011 City of Spokane Valley Community Development Department ne Building Division 11707 E. Sprague Avenue, Suite 106 410000ValleY Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: 13 't 2-0 L_ II 4.—` VE.R.A S • %2. 1 155- LYGt . o F (,', ‘) S"t{i Assessor's Tax Parcel Number(s): ex c ,µS r r Anz_v Exc. S Legal Description: PERMIT DESCRIPTION: Po 1.., e,,,,,_,-,,„,11G, 4 X 4 7 X ) 9- NC Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: L.A$Z,a Pasc> n Applicant: Phone: 9,;0-©c' 5 Fax: Phone: Fax: Address: 13L-at) a . 1 t Address: C i?/ 'P,I<'aK.l!ktJ� Lt y I( ii �A / City State Zip Code City State Zip Code n Contractor: ALP/A/6. ❑ Architect: Phone: qA7-yi93 Fax: 9 7-/o/S Phone: Fax: Address: ,5, 5-00 P NC-S Address: Po 6Fi 94);/-0 City State Zip Code City State Zip Code WA State Contractor License #:A L '1A1Gj3 LS-149 Contact: PAu . Rikr)1S1 PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: i DIMENSIONS: Z— #OF STORIES: r MAIN FLOOR TO SQ. FTG: 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: ®to& ,I 7- 2-- ..e-- FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: ONSTRUCTION TYPE: HEAT SOURCE: /D/ 6 t)/t- i//a, #OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 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: 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 Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: Alpine Custom Buildings, Inc. 500 South Pines 3108 CUSTOMER NAME ��� WSJ ALPIIVE Nc Custom Spokane Valley, WA 99206 BUILDING ADDRESS 134 2.0 E l FR-- Buildings PR/.f L 97-9/93 CUSTOMER PHONE Engineering Requirements S/L Wind Exp BUILDING REP Show bay spacing, open bays, partitions, including doors, windows, skylights, vents, sheds, etc. Show building frame type and roof pitch (clearspan, rows of poles, etc.). Show concrete slab and thickness. Show metal or wood type for roof and walls. Show north direction. //rte s 7--- ----i - , a 111 1 6)3 Ii Co Gki T ,„ x .. I117'5 " —4„4_ Pis. T- . / '_ NEW 12 SH o f' . 3$I -- e , , -.- 4 /3/ _.- '' e �,�wa ' ��; ; This site Plan is being submitted for the purpose of -----1"- � ADDRESS i '4_,O F ii ,�'_- obtaining la building permit and istrue and correct / `" representation of the proposal. known property ZONE /L ��5 lines/dimensions,curb lines,structuros and easements ROAD WiOTTH have been identified. Also indicated are wetlands, FRONT /VIA. FLANKING bodies , steep or other critical areas. COMMENTS a)e �� REVIEWED BY ��..:'+. - I Signed: Date: ••=3// `�/e l ( ACB-104A