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2000, 10-03 Permit App: 00008990 Remodel I I PROJECT APPLICATION WORK SH ET6 SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE,WA 99260 SPOKE COUKTY 509-477-3675 Project Description: c, TYPE OF APPLICATION wilding Permit ❑ Change in Use ❑ Grading Cl Manufactured Home Permit ❑ Relocation ❑ Sign ❑ Tenant (New/Change) ❑ Other SPECIFIC SITE INFORMATION Street Address: a ` Zc ,z2 �� ��-• iy Assessor's Tax Parcel Number(s): Legal Description: Deja , § FF1 �� � � I7� � werDistrict/Purveyor d widt - �* ��€ .-� �� *fig.k Y� m��aE Iva2z��,2 ?'- 0 _ School D tract ' r okbistrict s7'' t Zoning Y r t - OWNER/APPLICANT INFORMATION Indicate who should be contacted regarding this project ❑ Owner: Phone: ❑Applicant: Phone: Fax: Fax: Mailing Address: Mailing Address: City,State,Zip City,State,Zip Contractors (\ // - Phone%� ❑Architect/Engineer Phone Crt7 Fax` CJIv Fax Mailing address p J Mailing address �O. 3 1- (7i 1 City,State Zip City,State Zip - WA State Contractor licenseX Contact name: C c� O 2 l � 3a,0- � PROJECT INFORMATION B�tt��tng Informa ,< r ���� Building height to peak N of stories Main floor sq.ft. Unfinished basement sq.ft. Dimensions Total habitable space 2"d floor sq.ft. Finished basement sq.ft. Occupancy group Construction type Garage sq.ft. Deck sq.ft. Cost of project Heat source(electric,gas,etc.) a '44 Width: Length: What is the square footage of the sign How high is the sign? face? Year: Make: #of signs Area of existing signs Previous address Fire Sprinkler Tent Paint booth Fire Alarm Fireworks display Proposed use Value Firm Name Phone Plans Examiner Phone Inspectors: Address Inspector Phone O Concrete 0 Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Yes 0 No What is the current property size? If yes,identify 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,identify on site plan 0 Yes 0 No habitat area. Will the site be served by a septic system?0 Yes 0 No Is your property in a designated wildlife 0 Don't know 0 Yes 0 No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? If yes,identify on site plan If yes,identify 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 Is there evidence of fill or excavation on the property? property? 0 Yes 0 No If yes,identify on site plan 0 Yes 0 No Are 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 O Yes O No DEPARTMENT USE ONLY Is I? k?�3" �des gna edStc txnwater ir(uv1 Areae s pu 2 f �wer avatlable to she situ © No w,' -094: 3 � Y= .a "'"' . , 3;ailC$,,..z.. � • te Is th grope xtasxde the S s C7 No Is pnblfo it r atlable tc the sate? Nib s ,: • Is the y l�k • cfIstheCetlatedxtudt • • Date Received: Staff Representative: METHOD OF PAYMENT =MEE �; • fc VEVISA • ,\ SUBTOTAL ❑ CASH ❑ CHECK ❑ ❑ � '; ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: ICAL pE BANKCARD NUMBER: MINJMtMMPERMITFE; II,p5OoP ASE MAKE CHECILS MYA&WTo SPQICrS;t�tE AUTHORIZED SIGNATURE: ©UrTYPEKMC CEN 7ER`