2004, 05-12 Permit App: BLD-04-04336 Sinkpiikane
a0�Valley
Vr
BUILLtNG PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: `' / C
/t/
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
wilding Permit
❑ Relocation
'GT O/Y V % NK l C lJP 9'9lf i e/�er-
❑ Manufactured/Home
❑ Other
❑ Change in Use ❑ Grading
❑ Tenant Improvement ❑ Fire Safety
OWNER/APPLICANT INFORMATION
Owner:
Phone:
Address:
Fax:
❑ Applicant:
Phone:
Address:
City State Zip Code
❑ Contractor: f i/ J16 O -"r 00/.L-, 111Phone: ys�'�jaff Fax: //
Address:
City
State
Zip Code
WA State Contractor License #:f//J% j(/ 7i o
Fax:
City State Zip Code
Architect:
Phone:
Address:
Fax:
City
Contact: ..117474"t
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
21u FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?