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2003, 10-22 Permit App: BLD-03-02872 Finish Basement CITY OF 00111.1r NIIIIIk ., . e .000Valley 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 I REQUIRED SITE INFORMATION STREET ADDRESS: )5511 E 2151- a Spoiame Va.1if 1 W 9c1b3 ASSESSOR'S TAX PARCEL NUMBER(S): v LEGAL DISCRIPTION: PERMIT DESCRIPTION: -pivilqiiiiibet,lerinfoi- 0 BUILDING PERMIT a CHANGE IN USE a GRADING a MANUFACTURED HOME DRELOCATION 0-SIGN D TENANT 0-OTHER IOWNER / APPLICANT INFORMATION 1 ® OWNER: e 4- b(?i 0011 1---i f / 0 APPLICANT: PHONE: t)CIZ- S5(O FAX: PHONE: FAX: ADDRESS: 15511 E, 215+. a Spok-cneValle9 ADDRESS: CITY,STATE,ZIP . CITY,STATE,ZIP ®CONTRACTOR: at)ae' 0 ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,.STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# CONTACT: IPERMIT/BUILDING INFORMATION COST OF PROJECT: IuUU. GO 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT: 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 1 WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: IRELOCATION FIRE SAFETY 1 PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: I WA STATE NON-RESIDENTIAL ENERGY CODE 1 PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP I SPECIAL INSPECTIONS f ® BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): I BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: 0 COUNTY 0 CITY IS PUBLIC WATER AVAILABLE: ® YES 0 NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES ® NO IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES ® NO IDATE: 1 STAFF: ' METHOD OF PAYMENT: ® a O r alt&cer7 . VISA CASH CHECK BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE. *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD