2002, 05-30 Permit App: 02004227 Egress Window •
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I i PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
A SPOKANE,WA 99260
SPOK COUNTY
509 477-3675
N. , SPECIFIC SITE INFORMATION
L201t E 3--3D 1-)c))0 'C- v\iA- Li('i2 C.
I
f Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
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Project Description: G"C't4L SS Vv i f\t)c_' f h Of\`. 1\,1 LCL,i
0 Building Permit - 0 Change in Use 0 Grading 0 Manufactured Home Permit
0 Relocation 0 Sign 0 Tenant(New/Change) 0 Other
Department Use Only
Water District/Purveyor- Sewer District/Purveyor - - ,Road width act
Setbs ,
Fiont Rear.
School District Fite District: - Zoning _ _ -
Lcft Right
OWNER/APPLICANT INFORMATION
0 Indrivee who.thou/die ronta-Ied re ardrno,lhtr fnje.Y
1.3 Owner:
/ELi-1c`'y3( II t'jx:.\2 z hone: Z. \-j j,-/ l(( O Applicant:
kr 1 i? \y5FTil (;4t)v(
_6C, z Phone
�'�7� —'O L
1
Mailing.\Jdress: lading Address.
2c:,c;L 1 t .- 1,L 1-2C; li e 3'>i(t)
� 3 t�
(:.n,"tate,Zip
4-49L..-1(
_ C. City,State,Li -
0 Contractor Phone Cl Architect/Engineer Phone
fax Fac
Mailing aJdres
',Wing address
Cin,Slate Zip
City,State Ztp
A:A State Cnntracn,r hernsc= Contact nater-
PROJECT INFORMATION
Building Information
Building height to peak ft of stories Main floor sq.ft. Unfinished basement sq.ft.
Dinxnsinns Total habitable space a.d
A floor sq_It, Finished basement sq-It.
Occupancy group Construction npe Garage sq.ft- Deck sq.ft.
Co, o Arnica, I leaf source(electric.gas.etc)
Manufactured Home
Width: Length: What 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
SpeciaLInspections Required? • Non-Residential. Energy Code Compliance?
Firm Name Phone - .. •.
Plans Examiner Phone
Inspectors:
Address
Inspector- Phone
O Concrete O Welding ❑ Bolting ❑ Reinforcement Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? ❑ Yes Cl No
What is the current property size?
If'ei;identO,on site plan (square feet or acres)
ty
Is any part of the properwithin 250 feet of a shoreline?
What is the current use of this property?
Ifyes,idr„!ifi,on site plan O Yes Cl No
Is your property in a designated wildlife habitat arca? Will the site be served by a septic system?O Yes O No
_. Cl Don't know Cl 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?
Iffyes,ident.ifif Off site plan f pet,inren0 on the Jilt plan
Cl Maybe 0 Don't know 0 Yes 0 No O Yes O No
Are there any wetlands,streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
If yes,ide/It on site /an
p ❑ Yes Cl No O No
Are there slopes greater than 30°'0 on theproperty? 30 ft rise in 100 ft) Ole.
lie critical or hazardous materials used or stored on site?
°'") ❑ Yes Cl No
O Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
Is public sewer available to the site? Cl Yes Cl No
OYes 0 N
Is the property inside the ASA? O Yes Cl No Is public water available to the site? Cl Yes Cl No
OYes 0 N
Is the property inside the PSSA? Cl_Yes Cl No Is thepropertylocated within 1000 feet of a Natural Resource Area?
?
Dare Rcaised: Cl Yes Cl No
Nall Repn-secoatisc:
METHOD OF PAYMENT
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VISA
❑ (=AA! ❑ (Ill:CIC El IMBINMI ❑ • 0 _-
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
BANKCARD NUMBER:
TOTAL FEE
MINIMUM PERMIT FEE IS$35.00I'tL.S F_
AUTHORIZED SIGNATURE:
NUKE ca lt£Ct c p-il.ust E ro>I ot�lxti
COUNTY PER`ITONI}R