2000, 06-26 Permit App: 00005306 Tear Off, Reroof 1 1 PROJECT APPLICATION
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SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
11 SPOKANE,WA 99260
SPoxcri COURTY 509-477-3675
Project Description: Vt.,0 .•
TYPE OF APPLICATION
Building Permit O Change in Use 0 Grading 0 Manufactured Home Permit
0 Relocation 0 Sign 0 Tenant (New/Change) 0 Other
SPECIFIC SITE INFORMATION
Street Address: 13b 13 s 2—?
Assessor's Tax Parcel Number(s):
Legal Description:
Department:Use Only
Water District/Purveyor: Sewer District/Purveyor Road width Setbacks
Front: Rear:
School District: Fire District: Zoning
Left: Right:
OWNER/APPLICANT INFORMATION
EI Indicate who should be contacted regarding this project
0 Owner: Phone: AZ—Z..'"cjt,as t4 ❑
Applicant: Phone:in 33
31
e,r1c.. cDjHSU��• Fax: � t
Fax:
Mailing Address: Mailing Address:
13Lt3 G Z- IA" P o, C?)bx I t41-24D3
City,State,ZipCity,State,Zip
SPoVa4,,.c t L)A r►Ci Z Into 51ceiu,A. �� 4�e,
0 Contractor • Phone G z„,t7-&33 1 0 Architect/Engineer Phone
{�K �OL..5 Fax Fax
Mailing address Mailing address
P1v• I LI I7 (:::01)
City,State Zip City,State Zip
,Sc70*-e,,4,•e, 0 4 `lelZ 1
WA State Contractor license# Contact name:
WAat o3it Ai
PROJECT INFORMATION
Building Information
Building height to peak #of stories Main floor sq.ft. Unfinished basement sq.ft.
\Z' 1
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.)
LI"
4
a a
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
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?
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
Is your property in a designated wildlife habitat area? Will the site be served by a septic system?0 Yes O No
O Don't know O Yes O No , a 4 ,
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 O Yes O No
O Maybe O Don't know O 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 O 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?
( /%) O Yes 0 No 0 Yes O No ,,
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to'the site? O Yes El No
O Yes O No
Is the property inside the ASA? O Yes 11 No Is public water available to the site? O 'Yes a No '
0 Yes O No
Is the property inside the PSSA? O Yes 0 No Is the property located within 1000 feet of a Natural Resource
Area? O Yes 0 No
Date Received: Staff Representative: •