2002, 08-30 Permit App: 02007510 Porch Cover ,
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1 1 PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
!Ilk
SPOKANE,WA 99260
509-477-3675 757SPOKE COUNTY D2 f
SPECIFIC SITE INFORMATION
Street Address:
l5 ,: ( ? e'- Ila 51-7ojcane ) Gl,/g.
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: ?(n �f)rfi CO\) r 6-L'.1 (ot.c
[B'Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign El Tenant(New/Change) ❑ Other
Department Use Only
Water District/Purveyor. Sewer District/Purveyor Road width Setbacks
Front Rear.
School District- Fire District Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
0 Indicate who should he contacted n:garding this pry/eel
❑ Owner: Phone: ❑ Applicant: Phone:
Fax: lax:
Mailing Address: Mailing Address:
City,State,Zip City,State,Zip
Contractor Phone �/(� Phone
..i
��—`7 8�-��g3 ❑ Architect/lingnneer
-) i C €St ( V Fax las
Mailing address Mailing address
E. 3-( Pt I dyrr-f
City,State Zip Cin,State Zip
S�,lran L'" 9 o7
W AC r3 c a Contractor license# Contact name:
F/SCHC 4 9619Q1
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
Dimensions Total habitable space 2"1 floor sq.ft. Finished basement sq.ft.
Occupancy group C tstruction type v{ Garage sq.ft. Deck sq .ft.
YO- O
Cost of piec co I teat source(electric,gas,etc.)
0 op
Manufactured Home Sign
Width: length: What is the square footage of the sign I low high is the sign?
face?
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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?
hem Name Phone Plans Ir:xaminer Phone
Inspectors: '- Address
Inspector Phone
0 Concrete 0 Welding O Bolting 0 Reinforcement Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? 0 Yes 0 No What is the current property size?
If yes,ideate 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,identz,on site plan 0 Yes 0 No
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes 0 No
0 Don't know 0 Yes 0 No
Is any part of the property within a 100 yr flood plain? Arc or will there be wells located on the property?
Ifyes,identifyon site plan Ifyes,identifi on the site plan 0 Yes 0 No
0 Maybe 0 Don't know 0 Yes 0 No
Are there any wetlands,streams or ponds within 200 feet of the property? Ts there evidence of fill or excavation on the property?
Ifyes,identifr on site plan 0 Yes 0 No 0 Yes 0 No
Arc there slopes greater than 30%on the property?(30 ft rise in 100 ft) Are critical or hazardous materials used or stored on site?
( %) 0 Yes 0 No 0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? 0 Yes 0 No
DYes 0 N
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
DYes 0 N
Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area?
D Yes 0 No
Date Received: Staff Representative:
METHOD OF PAYMENT
',,!101111C,; SUBTOT\I.
VISA
❑ (.\Sl f 0 CI II1CK ❑ ❑ ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
ll:\'1'I1: EX PI TOTAL FEE
B:ANK(.ARD NIL\1BI'.R: MINIMUM PERMIT FEE IS.$35.00PLEASE
MAKE CI i8Cics PAYABLE TO SPOKANE
AUI'l fORI'/,I'D SIGN:A'PURI?: couNrY PtsRntrr CENTER
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