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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 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 E H No 0 g CID o C.) 4 fg § 2.4 xfewo A P >1.4tali SHEET #: 1 of 1 SINK WALL -..— 127" ,- 1 FILLER —1 1 1 1 1E- 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 E H No 0 g CID o C.) 4 fg § 2.4 xfewo A P >1.4tali SHEET #: 1 of 1