2003, 12-30 Permit App BLD-03-03359 Fire Damage Floor Joists1
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Valley
STREET ADDRESS:
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: 'A, Ale /Z . 7,)g, •Ifcsii.4 y
13BUILDING.PERNIIT EICHANGE .IN.USE $] GRADING
®RELOCATION ®'SIGN ®ttNANT
CIMANUFACTURED HOME
DO Oita
OWNER / APPLICANT INFORMATION
®OWNER: ev 4 to /T
PHONE: 44 et 6' I-,3415frAX:
ADDRESS: Z/9 o yj 3 . / s r i G/„�/p /,MA.. ADDRESS:
CITY,STATE, ZIP
®CONTRACTOR: 4/P S." vi c9 -; @ . ® ARCHITECT:
PHONE: 6-35-- 0So % FAX: 6-3G -7Sl Z PHONE: FAX:
APPLICANT: 7i9/I- ,ajt d c < jfl, (', •
PHONE: S 3S-9S0 J FAX:
//
536- 7SJ
CITY, STATE, ZIP
ADDRESS: 77/3 A! 6• ',ace 96.e 992,82, ADDRESS.
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE #
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: fT S
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
oD
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:.
CONSTRUCTION TYPE:
MAIN FLOOR SQ FT:
2ND FLOOR SQ FT:
UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: GARAGE:
CURRENT PROPERTY SIZE: COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
i
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER:
ADDRESS:
PHONE: FAX:
INSPECTOR:
ADDRESS:
CITY, STATE, ZIP
PHONE: FAX:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
® BOLTING ®CONCRETE ® REINFORCEMENT
FIRM NAME:
INSPECTOR(S):
PHONE:
® WELDING
FAX:
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: ® YES CI NO IF YES: ® COUNTY ® CITY
IS PUBLIC WATER AVAILABLE: ® YES ® NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES ® NO
IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: ® YES 0 NO
METHOD OF PAYMENT:
0 0 0
CASH CHECK
BANKCARD #; EXPIRES: V/N #
AUTHORIZED SIGNATURE:
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD