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HomeMy WebLinkAbout2003, 09-25 Permit App: BLD-03-02593 Change of Use sornakanoee\.....00 ��ljl1, �s�i PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: /- _ ( 0 69 l ASSESSOR'S TAX PARCEL NUMBER(S): 'S.5-.2 I/3 o ()CI LEGAL DISCRIPTION: ./0 9 n L 1/ - / Z 6s a P f 7101;),t-A /S 4 cJ I7-7 c�� PERMIT DESCRIPTION: C u c,--- S ad< a A-e L A(aBawe Z ULLDING PERMIT CI CHANGE IN USE D GRADING a MANUFACTURED HOME DRELOCATION C SIGN 1 TENANT Q OTHER OWNER / APPLICANT INFORMATION ® OWNER: JI rA ® APPLICANT: PHONE: Sj(QSc?! ,FAX: PHONE: FAX: ADDRESS: ; 6/04, /7 /17SO(Cc7.�< uQ 191/Z ADDRESS: / CITY,STATE,ZIP CITY,STATE,ZIP ®CONTRACTOR: ® ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,.STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: LOCO, 00 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT: &7 2— BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT: NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT: NUMBER of BEDROOMS: � CRITICAL AREAS: GARAGE: FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: REAR SETBACK: CURRENT SEPTIC USE: LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: IMANUFACTURED HOME SIGN WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: RELOCATION FIRE SAFETY PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP I SPECIAL INSPECTIONS I ® BOLTING °CONCRETE 0 REINFORCEMENT ® WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: ® YES a NO IF YES: ® COUNTY 0 CITY IS PUBLIC WATER AVAILABLE: a YES ® NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES ® NO IS THE PROPERTY LOCATED WITHIN ASA: a YES ® NO PSSA: 0 YES D NO hDATE: I STAFF: METHOD OF PAYMENT: ® ® O r - CASH CHECK r VISA ■Ilam. BANKCARD#: EXPIRES: VIN# AUTHORIZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD 1.41,40,) 12 12 1 e.e.xcitsr-- 2 12 16 titeno\Ce 4,e e 28 24 a -- f • C,, Tiw/ø.3t .3ugr Ae7. 47- II .�. WI � I I II ....I. i 11I11• { I 1 I i . , I . . � .. .� I I I I ' • -1 i-' -4- / -4.-- -1- 72;7*, - . Wizi, I ././ . I I , I 11142 '1) 1 I I I . r._�.;rx�l c� ,�';t�'' -�...I._._I r __I � I,.. ..i.__.�._._i •4 I I I 1 I I I X . I • -+ww -1. ...L ! ......1...... , ...1 -.J._.__ _ .L,. .i. � 'r ,� J ............�.. r_,......... i... ._i I I� I I _ � • i I 1 I I I I i I __ _ I _ I I �' 1 I I 1 I I ` I I I 1 1f �4'X 47 ..7‘_,. 1 .. Ifi {I I _._ -.._...R4.7 l .t ;1- 0 -__-.- _.-.,..p -..-V., -. I �_r" r l l • I�I 1 . 1 ! f 1 . .. .... . I.. .._t t-.,14./Ait .r_-...-.--.... ...-__...... ..._._ 1 r... ..._.( I I I I I 1 ' 1 I , 1 1 i As-i". .I .....r_.___ ....__....__......__-___...__....._..._.. ..„.__. ....r I 1. 144 }J •_--_r_ . 1..0. e', ...:4.?'" .....4Z,...__ _ 4o..4-.= 40... ! .45'7'" , . . ' _I e'�11 I 1 I i I ',_ 1 , _ 1 . i I r.. - j 1 I _-1___._±..------` ItS'!$f`.E1�1 , • ' ,. '� • 1 ._1 ,..L.........1...__...74_1......±......._ ��,, '�"' .-.__ • �1 _ i , i I, I11I" ,_' 0 � 1164P1 icit". I I Job Name —/--2--'"•• - r 4 / r 102(J Job Number _ --- Laotian 4j0C /cess JO ,'— r�it y Sbec / of 9'41. Technical Representative .. . _— tkf �Q4tu r � •P 7 .7.-1 I r•JT IOL•n I I n._L- I rnn r---.. 1 nen ] nu I .,IOSI I Ln•,rf 1-nrf-9 i_-, , ,n 1 1X- 2 pit 1 1t-s1 ./.' � L\ S SL taf oC. • le 10 z-!- I to © C. i8 )( SA'' u3a��S y