2000, 06-19 Permit App: 00005103 Remodel DD-616 .3 4, i4,, ,,.. 6 ,
i -PROJECT APPLICATION
ik SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
1 1 SPOKANE,WA 99260
SPO COUI'1'y 509-477-3675
Project Description: 'ic1 1-, /1eei 7'A V�"/rn6 (lP_
TYPE OF APPLICATION
d
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Ho e Permit
❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other
SPECIFIC SITE INFORMATION
Street Address: /3 4/03 F /5 77) ,----
Assessor's Tax Parcel Number(s):
Legal Description:
Department Use Only
Water District/Purveyor: Sewer District/Purveyor Road width Setbacks
Front: Rear:
School District: Fire District: Zoning
Left: Right: e..)F)
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
❑ Owner: Phone:9,?17-6?-3/7 ❑ Applicant: Phone: _/L,1 7Z/Z,,Z-3
I
/9,--r4 ' C h Fax: Gt K 1 (6 1\e e J y Fax:
Mailing Address: Mailing Address: N
Si i 00 0 Goss
City,State,Zip City,State,Zip
r nP?/ (A), 99oe y
❑ ntract e Phone �//' 7z/z.3 C71Architect/Engineer Phone
J, le.e oI s� pore cle) ax Fax
Mat'Maijiog address Mailing address
li3EC) z Gates
City,State• ip City,State Zip
GAPn 0y GU/C
c take ccEense5— Q 2�7 kJ/
J/ Contact name:
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
l
Dimensions Total habitable space 2"a floor sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft. Deck sq.ft.
Cost of projec# 70 0 Heat source(electric,gas,etc.)
Manufactured Home Sign
Width: Length: ,r• What is the square footage of the sign How high is the sign?
face?
Year: Make: #of signs Area of existing signs
Relocation Fire Safety
Previous address Fire Sprinkler Tent
Paint booth Fire Alarm Fireworks display
Proposed use Value
Special Inspections Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors: Address
Inspector Phone
El Concrete El Welding O Bolting O Reinforcement Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? Cl Yes O No What is the current property size?
If yes,identify on site plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
If yes,identify on site plan O Yes O No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?El Yes O No
O Don't know O Yes O No
Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property?
If yes,identify on site plan If yes,identify on the site plan O Yes O No
O Maybe O Don't know O Yes O No
Are there any wetlands,streams or ponds within 200 feet of the Is there evidence of fill or excavation on the property?
property? O Yes O No
If yes,identify on site plan O Yes O No
Are there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( - %) El Yes O No O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes O No
El Yes 0N
Is the property inside the ASA? 0 Yes Cl No Is public water available to the site? 0 Yes El No
0 Yes 0 No
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource
Area? 0 Yes 0 No
Date Received: Staff Representative: