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2003, 08-06 Permit App: BLD-03-02161 Porch . . PROJECT APPLICATION WORK SHEET '' SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT Ati_i1026 WEST BROADWAY AVENUE 44 SPOKANE,WA 99260 111 509-477-3675 SPOIW\T COUN IIY SPECIFIC SITE INFORMATION Street Address: j I vI 3 \ y2 Assessor's Tax Parcel Number(s): Legal Description: • I\ Project Description: P-> ,-k Q Gl l \ t.o---,,1 ❑ Building Permit 17 Change in Use 17 Grading 171 Manufactured Home Permit 171 Relocation CI Sign 17 Tenant(New/Change) I7 Other I epar aent.Us'e Only Water District/Pu veyor. Sear byct/Purveyor Road width Setbacks a' Front ;�' fi t r a r School fltstttct Zoning —Left �a �P1tepistrick OWNER/APPLICANT R ET Indicate mho should Ge contacted reRarddngMATION this project \ CI Owner Phone: 9 Z. '. i7 7 2— ❑Applicant: Phone: Fax: Fro dl V-2 0'y i f. Fax: Mailing Address: Mailing Address: /v I0 l_' 3I � City,State,Zip City,State,Zip ❑C(oontractorit-4 /Phoone- 3 Z v � k ❑Architect/Engineer Phone I-J i_� i l ei j �-l� �Js t'c Ic�I ,� Fax Mailing address �/ �-- Mailing address /0( S i�l. S—Tree l City,State Zip City,State Zip WA State Contractor license# Contact name: 1J ( / l L,0 C S C.)--- 0(.- . PROJECT INFORMATION ding .formafiion Building height to peak #of stories Main floor sq.ft Unfinished basement sq.ft. / I3 Dimensions Total habitable space 2nd floor sq.ft. Finished basement sq.ft. / X 1 O Occupancy group Construction type Garage sq.ft. Deck sq.ft. Cost of project Heat source(electric,gas,etc.) /'i 0 00 Manufactured.Home Width: Length: 'sV cr is the square footage of the sign How high is the sign? face? Year: Make: #of signs Area of exist ng signs Relocation Fire Safety Previous address Fire Sprinider Tent Paint booth Fire Alarm Fireworks display Y 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 O Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION `/ Are there structures on the property? fa.Yes O No What is the current property size? ( ' If yes,identt on site plan (square feet or acres) ' f Is any part of the property within 250 feet of a shoreline? What is the current use of this property? Ifyes,ident,6 on site plan O Yes C2,No I �, �� } <� ` y Is your property in a designated wildlife habitat area? Will the site be served l4 a septic system?O Yes No Cl Don't know O Yes 52t No Is any part of the property within a 100 yr flood plain? Are or will there be wells located on the property? Ifyes,ident,51 on site plan Ifyes,ident61 on the site plan O Yes ,_ No O Maybe CI Don't know O Yes No Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property? Ifyes,identi_fi on site plan O Yes -'No o Yes pi.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 No O Yes j"No DEPARTMENT USE ONLY Is the property in des �d t�srnuwate ControlArea? Is ptblic sewer a siJ ble to tFre site? 0 Yes 'es k 2.7a' Is dt t per.? i 'yes t o Is pubs wat t asap es: o Q Yes © ta=°, Is*.e.proms rude t t'S A? : D Yes # t'I© Is 1:1 iirsperty touted. 1000 feet.ofaTata.ratResourte Aria? Date Received: Staff Representative: METHOD OF PAYMENT 111111111111 SUBTOTAL 0 CASH 0 CHECK 0 0 . 1 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: 'TQ'T�i1 pEE' BANKCARD NUMBER: Mitatit!►tFL tilif Fl i'ls,xt£At/.EASR MAKE cnEcKS I'ATAS "is) iEMN&- AUTHORIZED SIGNATURE: Cauri2Y�tt C NT .. 0 APPROVED 81t-