2004, 12-27 Permit App: 04009531 ReroofIFROMtj RLPINE CONSTRUCTION
Span
,,,Valley.
STREET ADDRESS'
ZZ 11
FAX NO.
: 5094485504
IS' -.
Dec. 23 2004 12:40PM P1
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206.
Phone: (609)688-0036 Fax: (509)685-0037
REQUIRED SITE INFORMATION`
4,1 tat
2.1- I N AesS,e"
K77
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL INSCRIPTION:
PERMIT DESCRIPTION: Rao o'lc
jrzumnrNG FERMTf
QRELOCATION
CI OWNER -
PHONE:
ADDRESS:,/� ...4/
PHONE:
.. I��/.CONTRAC`T'OR: rT (-chair to* sr12. Grj o✓
. ,.
PHONE 7 y s 8099 FAX: 8• S-5-0 }/
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CITY, .STATE.. ZIP
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O CHANGE.N USE • Q GRADING
QSIGN • (]'TENANT
MANUFACTURED HOME
DOTHER
OWNER/ APPLICANT INFORMATION
FAX:
ADORESSLY /T E SL(.WG«(
WA ST CONTRACTOR LICENSE
C. APPLICANT:
PHONE:
ADDRESS:
0 ARCHITECT:
PHONE:
ADDRESS.
CONTACT'
FAX:
CITY, STATE, ZIP
FAX:
DA/luJ
/2-A/Pe
CITY, STATE. ZIP
PERMIT/BUILDINGINFORMATION
COST OF PROJECT: 27 Sa --
BUILDING
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK -
REAR SETBACK:
LEFT SETBACK -
RICHT SETBACK:
DEC 23 2004 11:37
30%SLOPES .ON PROPERTY:
OCCUPANCY: GROUP:
CONSTRUCTION TYPE:
MAIN FLOOR SQ FT:_„
ZNo FLOOR SQ FT:•
UNFIN BASEMENT:__.
STRUCTURES ON PROPERTY' FINISHED BASEMENT:
. CRITICAL AREAS.:C''-‘;'"GARAGE:
CURRENT PROPERTY:SIZE: COVERED DECK: J
CURRENT. PROPERTY USE: DECK:
CURRENT SEPTIC USE`•
CURRENT WELL USE'
IMPERVIOUS' SURFACE AREA'
5094485504
PRGE.01