2005, 02-03 Permit App: 05000334 Safety Inspection*lane
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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: 7-22 22. Sc3o ch
Assessor's Tax Parcel Number(s):
462-41, 15 o R
Legal Description:
PERMIT DESCRIPTION:
Building Permit
Relocation
Li Change in Use 1 I Grading ❑ Manufactured Home
Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner:
Phone:
Address:
12°ovs-
Fak:
City
f—I Contractor:
Phone: Fax:
State Zip Code
Address:
City
State Zip Code
WA State Contractor License #:
❑ Applicant: C-C.(Pcuti& Cl e ✓v7ctt be
Phone•5aq 34242x3 Fax
Address 1 22 3. 6 rt,&
5p0 koNAc ( co A 9 4 d or;
City State Zip Code
Architect:
Phone
Address.
Fax:
City
Contact:
State Zip Code .
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 PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM'?