2005, 06-02 Permit App: 05001905 Remodel . -) ! iG ,
BUILDING PERMIT APPLICATION WORKSHEET
cITY
� V City of Spokane Valley Community Development Department
�� Building Division
u
91707 E. Sprague Avenue, Suite 106
aleY 4000VaSpokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 51 a 3 2 /G VO • (10,1--ety ) )4 9Z Z
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit ❑ Change in Use ❑ Grading El Manufactured Home
Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
•
❑ Owner:4,ViLt t1�� ,lC( `� :)a Applicant:
Phone: Fax: �( Phone: Fax:
Address: Address:
City State Zp Code City State Zip Code
pt Contractor: Cfz-+-¢-r5rvt 1 ] Architect:
Phone: 6841• 2.214.-7 Fax: 53c,- 1-geo Phone: Fax:
Address: / 3 ru • bry Address:
City State Zip Code City State Zip Code
• WA State Contractor License#: R-0'�Tc�o IL'1)7 Contact: ) r--- 14 n n-�-�
Spokane Valley Bus. Liscense #: Contact
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 2""FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
To11.11111Pr 1.111111k HABITABLE SP ACE AREA:
COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
°Ci I " 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 w` � n ait,'MZ414 Sign
i -
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check Masted ❑ VISA ❑ Other
Bankcard #: QP Expires: VIN#: 41111_
Authorized Signature: P4` This document originally contained
_ confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
(E) CLOSET
REMOVE IC1
(E) PIASTER BEDROOM
A
(N) MASTER BEDROOM
SMOgE
Dpsecr°11
d Laundry Room
UNFINISHED EXISTING BASEMENT
1-9
(N) LAUNDRY &
MECHANICAL ROOMS
R-1 REMODEL DUSTING SINGLE FAMILY RESIDENCE
PROJECT: Remodel 27.5 Sq Ft Existing Master Bedroom
into new Storage Closet and
Remodel 171.5 Sq Ft into new Laundry Room
WASHER/DRYER WALL
129"
5-0 X 28 FIXED
L_
WHEN INTERIOR ALTERAIIONS. RAMOS OR ADDITIONS
REQUIRING A PERMIT OCCUR. ON MOON OR MORE
SLEBEN ROMS ARE ADDED DR CREATED IN EXISTING
ONELLINGS. DIE DWELLING WIC SWILL BE PROVIDED
PITTHSNIONE ALARMS LOCATED AS fiLDWRED NBV
DWELLINGS.
NOTES
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• 11101„ AR0VE PIMA MAX.
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r DATE:
MAY 31. 2005
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SINK WALL
-..— 127"
,-
1
FILLER
—1
1
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JII
12 5 36
13
30
----ril
0530
F1
1
830
WHEN INTERIOR ALTERAIIONS. RAMOS OR ADDITIONS
REQUIRING A PERMIT OCCUR. ON MOON OR MORE
SLEBEN ROMS ARE ADDED DR CREATED IN EXISTING
ONELLINGS. DIE DWELLING WIC SWILL BE PROVIDED
PITTHSNIONE ALARMS LOCATED AS fiLDWRED NBV
DWELLINGS.
NOTES
K e e
• 11101„ AR0VE PIMA MAX.
„ DiECI „ „ 0 „ 0913EINVE E „ U. Ill 0 „ V 1.711 WIN Eit 9
r DATE:
MAY 31. 2005
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No
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SHEET #:
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