2004, 09-08 Permit App: BLD-04-07596 Tear Off, ReroofSP
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• BUILDING 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: /3/> A/ •iq.c-r- Rd.. •
Assessor's Tax Parcel•Number(s): •
Legal Description:
/Ie_11. 14. 9qz_/
o - plc?
PERMIT DESCRIPTION: PQ
Building Permit El Change in Use D Grading 0 Manufactured Home
Relocation 0 Tenant Improvement LJ Fire Safety 0 Other
OWNER/APPLICANT INFORMATION
0 Owner: arc-ii-ki )-(L 0 Applicant:
Phone: • --) . x: . . - Phone: Fax:
Address: 13. M ei:e4-7(d . - Address:
"- a ili1/'1k1 k4. .- qz/L
--1 State . Zip Code - City , State Zip Code
. 0 Architect:
Phone: Fax:
0 Contractor: •
Phone: Fax:
Address: Address:•
City
State Zip Code City
WA State Contractor License #: Contact:
State , Zip Code
PERMIT/BUILDING .INF.ORMATIO)
-
HEIGHT TO PEAKDIMENSIONS:
•
.
# OF STORIES:. . / .. .
MAIN FLOOR TO so: 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 pROJE,C_T: -
• Iv _://,00, oa'
'
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
1 'SYSTEM?