2005, 07-08 Permit App: 05002307 Siding*lane
Walley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
s 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:
s6 /S. Sees „wimp Kay. 99�4
Assessor's Tax Parcel Number(s):
Legal Description: 1.I n 'c1
PERMIT DESCRIPTION: \IhII r5t ,Wi\c nTfn n PailtLu
Building Permit
Relocation
❑ Change in Use v ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement 0 Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
0 Owner: )AVI d JYYL I t-11
Phone: Fax:
Address:
0 Applicant:
Phone:
Address:
Fax:
City State Zip Code City State Zip Code
❑ Contractor: mo '',ir•co zLti`g i fl Architect:
Phone: (-181,38 .3 3 Fax: -5a O - Phone: Fax:
Address: &7.2-8- C 61100 r� Address:
CKy ®y wt Ld")✓Q/ , e Zip e City /� State Zip Code
WA State Contractor License #;/ in,1(! S()LtaeAContact: `' pilti, n -i'
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" 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 PROJECT4 0.5 ,0o
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC -
YSTEM?
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
Bankcard #:
Authorized Signature:
cg Check
0 Mastercard
0 VISA
Expires:
❑ Other
VIN#: