2004, 12-27 Permit App: 04009530 ReroofFROM ALPINE CONSTRUCTION
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FAX NO. : 5094485504 Dec. 23 2004 12:44PM P1
• . PERMIT APPLICATION WORK SHEET es/`C
SPOKANE VALLEY COMMUNITY DEVELOPMENT g
BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206.
Phone: (509)688-0036 Fax: (509)688-0037
REQUIREDZITeINFORMATION
STREET ADDRESS:
2_i-° • 1
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
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Bess' C'
PERMIT DESCRIPTION: -17—e Rs= 0
UIIAING.YERMI'T • f CHANGE.IN USE :. GRADING
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OWNER /APPLICANT INFORMATION
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OWNER: CI APPLICANT:
PHONE:
ADDRESS:
FAX: .....:..:;... :.: ,:.,,PHONE -
ADDRESS:
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CONTRACTOR: ALP,»t 61937-A.0 5n70.i%.
PHONE: Y/ 9 ea y 9 FAX: 'Hs 'fD
ADDRESS- 4/WC 6 4CVNr/'Itr PA f 9223
CITY,. STATE, ZIP . ..
WA ST CONTRACTOR LICENSE *ALP dN G M!. :O 9 CONTACT:
FAX
CITY, STATE, ZIP
ARCHITECT:
PHONE: FAY:
ADDRESS -
CITY, STATE, ZIP
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PERMIT/BUILDING'INFORMATION
COST OF PROJECT: 275—c2 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
BUILDING HEIGHT TO PEAK. OCCUPANCY. GROUPS 2'+o FLOOR SQ FT:
BUILDING DIMENSIONS: .:CONSTRUCTION:TYPE; : UNFIN BASEMENT:
NUMBER OF STORIES: STRUCTURES ON PROPERTY. FINISHED BASEMENT:
R ....,,., .;r GARAGE:
NUMBERot BEDROOMS: � � '" " � .��CRITICALAREAS'"� '
FLANKING SETBACK' CURRENT PROPERTY. SIZE: COVERED DECK:
FRONT SETBACK. CURRENT PROPERTY DECK:
REAR SETBACK. CURRENT SEPTIC USE:
LEFT SETBACK- CURRENT WELL USE:
RIGHT SETBACK- • IMPERVIOUS SURFACE AREA:
DEC 23 2004 11:41
5094485504 PRGE.01