2004, 08-02 Permit App: BLD-04-07202 Garage BUILDING PERMIT APPLICATION WORKSHEET
SITYt>€ City of Spokane Valley Community Development Department
ne
potaBuilding Division
11707 E. Sprague Avenue, Suite 106
ValSpokane Valley, WA 99206
40111, leYPhone: (509) 688-0036;Fax: (509) 688-0037
REQUIRED SITE INFORMATION -
:,
Street Address: id-023 C . a5-)-L ickifkva.
Assessor's Tax Parcel Number(s):
- Legal Description: X-isi cAu- ,a ca, S 1 \ \--vj,.ci„,qcl-c,,o,y,
PERMIT DESCRIPTION: tc3w( kA,?1, ,ptia 1,1Ck tQL , • � ' - •
8 Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
Relocation El Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
•Dro Or
7L Owner: ) S:1 r„ \\-Rç1ca3 c ❑ Applicant:
Phone: (L5 Fax: Phone: Fax:
Address: j 5 t . a f\wi ,a_ ' Address:
City .1' State Zip Code City State Zip Code
❑ Contractor: •❑ Architect:
Phone: Fax: Phone: Fax: -
Address: Address:
City State Zip Code City - State Zip Code
WA State Contractor License#: Contact:
PERMIT/BUILDING.INFORMATION
HEIGHT TO PEAK /
7 i DIMENSIONS:a. , i11 ! MI #OF STORIES: j
MAIN FLOOR TO SQ. FTG: 2 FLOOR SQ. FIG: �( UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: C NSSTRUCTI� IONN TYPE: HEAT SOURCE:
vrniL
#OF BEDROOMS: 1OTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: all ;2, IIA 0 DO 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
1 Uv 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 0 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
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard).
❑ Cash ❑ Check 0 Mastercard 0 VISA
❑ Other
Bankcard #: Expires: VIN#:
•
Authorized Signature:
•
11\SCITYke DEPARTMENT OF COMMUNITY DEVELOPMENT
oatilCURRENT PLANNING
.0,00Valle ADMINISTRATIVE EXCEPTION
APPLICATION AND DETERNIINATION
PART I
APPLICANT: USZ)3 'CX
MAILING ADDRESS: r ✓ & CS1
CITY: 5vo(sktV J4 I 1 STATE: J� (�(�ZIP: _9_ C 1
PHONE:(HOME)- O/)L / (WORK) (CELL) 5 aq jC4 I -,-111110
NOTE:IF APPLICANT IS NOT THE OWNER,INCLUDE WRITTEN� OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW
SJ GAS GOA s
LEGAL OWNER: Ct
MAILING ADDRESS:
CITY: , STATE: ZIP:
PHONE:(HOME) (WORK) (CELL)
TAX PARCEL No: STREET ADDRESS OF SITE: ,o €• 050N-• /\\J
LEGAL DESCRIPTION: 1k WC) cJ\N �`
JJJ
SECTION(S) TOWNSHIP RANGE
ZONING CLASSIFICATION: IJI.Ki COMPREHENSIVEpnPLAN.. jCATEGORY:: p
TYPE OF ADMINISTRATIVE EXCEPTION REQUESTED: s-d)9 . i?` ' daxod
-TtA-Y"-W
.s-k-J4) -k-0 )0i) 51-1 Ulff4ctra ,M._,
EXPLAIN REASON FOR REQUEST: A)'J( L ( ) 30\ivi .1-70 czbt, �l
-�Y C cc �9.1^0 x,Uk c % -ti,-
APPLICABLE SECTION(S)OF ZONING CODE:
NOTE: A SITE PLAN AND SUPPORTIVE DOCUMENTS SHALL BE INCLUDED WITH THIS APPLICATION
4 •
PART II
LEGAL OWNER SIGNATURE
)n (Signature of legal owner or representative as authorized by legal owner)
I, k,S S ( C , (print name) SWEAR OR AFFIRM THAT THE
ABOVE RESPONSES ARE MADE TRU7 �Y AND TO THE BEST OF MY KNOWLEDGE.
I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA PROPOSED
FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER, ATTACHED
HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY ACTIONS ON
HIS/HER BEHALF.
ADDRESS: I a5 P \r"U\-Ak., PHONE: 509' GI 3
(city)
'(�, ' ( k` 1;'•0\ ZIP: "I c \4
( ity) 0 (State)
• (Signature) 4 (Date)
NOTARY
(For Part II above)
STATE OF WASHINGTON ) ss:
COUNTY OF SPOKANE ) '
SUBSCRIBED AND SWORN to before me this �'�'1ek day of a ,20 D f`("
NOTARY SEAL �� ���•
„�\\\ NOTARY SIGNATURE
QQs$SN LL4 ‘1 Notary Public in and for the State of Washington
% � 0 F 4g �► Residing at:
jcoc,IypTARY
N Fhb B:tC4 A i My appointment expires: lt)J' 7 f®n
41 4
0:o w
PART III
(To be completed by the Planning Staff)
DATE SUBMIT
9I1' RECEIVED BY: Ae. i6AA CI a.„0
FEE: FILE NO.: —9-1
r
•
PART IV
DETERMINATION
File No: AEI -
The Department of Community Development finds that the information provided by the applicant and required
compliance with the City of Spokane Valley Zoning Code and all other development regulations, does/does not
adverse affect on the adjacent properties nor the public's general health, safety and welfare.
The Department of Community Develop s' nt approves / s'•Hies this"Administrative Exemption" as conditioned
below,for the property described in Part I, . _ ant . - tions 14.506.000 and 14.506.020 of the Zoning Code.
This administrative exception is subject to the following conditions of approval:
1) This administrative decision shall apply to the subject property indefinitely and may be transferred to future
property owners, heirs or any successor in interest to the property subject to the conditions of approval
contained herein.
2) The applicant and property owner shall comply with all requirements and regulations of the Zoning Code.
3) The applicant shall comply with all applicable development regulations and standards.
4) The applicant and property owner shall comply with the following additional conditions:
This administrativ exception' h-re,yapproded this 0 day of 1." / OW' , 2014'
Approved : l �v l ��/ t 11
Title: �- J fie J1
b
Under Section 14.412.041 of the City Zoning Code, any person aggrieved by this administrative determination has
the right to appeal this administrative decision to the City of Spokane Valley Hearing Examiner. An appeal must
be filed by submitting the appropriate appeal application together with the required fee to the Department of
Community Development Current Planning,within fourteen(14) calendar days after the decision is issued. Upon
receipt of a complete appeal application,a public hearing will be scheduled.
For information or questions,please call(509) 921-1000 Rev 6/03
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PLANNING DEPT. APPROVED
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