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2003, 11-26 Permit App: BLD-03-03150 Finish Basement CITY OF010":11411111% ` 5 so O�/ � 400Valley 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 REQUIRED SITE INFORMATION 1 STREET ADDRESS: ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: PERMIT DESCRIPTION: ►� 'UILDING PERMIT CI CHANGE IN USE D GRADING •O MANUFACTURED.HOME URELOCATION 0-SIGN Q TENANT D OTHER OWNER / APPLICANT INFORMATION 1 7. OWNER: #Pr-`' IA) "' "Tu s ® APPLICANT: Spy 9g C)-.1 '1 2 /PHONE: C /( 70 3`l cZ FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,STATE,ZIP - CITY,STATE,ZIP ®CONTRACTOR: ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,.STATE,ZIP - CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: OO 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: (6,DU BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: - y 2ND FLOOR SQ FT: 3&° BUILDING DIMENSIONS: 3b XZZ CONSTRUCTION TYPE: 3100 K UNFIN BASEMENT: NUMBER OF STORIES: Z STRUCTURES ON PROPERTY: 64 Rik-el- FINISHED BASEMENT: NUMBER of BEDROOMS: Z CRITICAL AREAS: l� VLtiti GARAGE: FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK: FRONT SETBACK: CURRENT PROPERTY USE: DECK: /9 X l0 REAR SETBACK: CURRENT SEPTIC USE: sae- LEFT e-LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: IMANUFACTURED HOME SIGN WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: I RELOCATION FIRE SAFETY I PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: I WA STATE NON-RESIDENTIAL ENERGY CODE I PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP 1 SPECIAL INSPECTIONS I( f 1:1 BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): I BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: 0 YES ® NO IF YES:IF ® CITY IS PUBLIC WATER AVAILABLE: 0 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 0 NO PSSA: 0 YES 0 NO IDATE: I STAFF: METHOD OFPAYMENT: 0 0 O r 0 immomm fRIshyarri: VISA CASH CHECK k. — isimum BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE: dAjAei fZc 64--J----- *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD