2003, 11-05 Permit App: BLD-03-02985 Window••••%.,„
Sliokan' e
.0.0Valley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
19707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: 3C--)5 S ?]t,A44.5 ;
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: L40 1ti0 V�� 45 \j3 )-c am
PERMIT:DESCRIPTION:
[ �II,DING PERMIT O.GUNGE .IN USE • a GRADING
°RELOCATION ®-SIGNTENANT
® MANO' FACFURED HOME
0.0THER
OWNER / APPLICANT INFORMATION
CI OWNER: 'eMk\ 5eNerADl\ CI APPLICANT:
PHONE: la'lb 0 FAX: f PHONE: FAX:(
ADDRESS: 11 LOC) J, t V -/k �p t i i.4. CAM, 5'4 1_1-7 ADDRESS:
CITY,STAT!~, ZIP - CITY, STATE, ZIP
®El
CONTRACTOR: �2-iLwk
1 {-i.-Ak1F1
PHONE: C'S.(.0{{ Cr- CD --1 FAX: PHONE: FAX:
ADDRESS: 1� S• 1131(V M2 Z0 QsNe.-.”.ne 10- Nob
CITY, STATE, ZIP
ARCHITECT:
ADDRESS:
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:l5o0
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
'NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
OCCUPANCY GROUP: 2N0 FLOOR SQ FT
CONSTRUCTION TYPE: 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:
IMPERVIOUS SURFACE AREA: