2004, 07-02 Permit App: BLD-04-07011 DeckBUILDING 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: S 0 Q3 N- 60/i Uoil-
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: ID 0.1. I
P4.
d o u.S Q o'Y o f (Cr -gal\
El Building Permit ❑ Change in Use ❑ Grading
O Relocation ❑ Tenant Improvement 0 Fire Safety ❑ Other
❑ Manufactured Home
OWNER/APPLICANT INFORMATION
O Owner: is b A -I Rut f Qi q e- 0 Applicant:
Phone: _ - gFax: /U J I Phone: Fax:
Address: S�Oa A. (fir, ); c o - RA , Address:
s dl or t4)7 qqa/6
Gill State Zip Code
// City
❑ Contractor: a d, Aq 4 Go/ri�'7 0 Architect:
Phone:9.ZZ 73 7y/Fax: Phone: Fax:
Address: l'2,/ 2. 1Ko>,� e.re/ !o/
1.
1124 6
Ci State Zip Code
State Zip Code
WA State Contractor License #:
1
Address:
City
State
Contact: $7 e Bi i d scr
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?
09/08/93 06:44 $509 324 1567 SP CT -Y HEALTH
SEP -07-'93 15:5? ID:UTILIT'r SPD 1. TEL NO:509-456-4715
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ADDRESS
ZONE
ROAD
FRONT
COMMENTS
REVIEWED BY
l¢] 0 01
#109 P02
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TYPE OF SEWAGE SYS
SPECIFICATIONS
TELINEAL 0R SQUARE _pa.'°
0 ARE FOOTAGE.: _ t t S
TRENCH WIDTH:•r
OEPTil FROM ORICrNAL GROUND 'RrT�E 0 80
OF SEWAGE SYSTEM:
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OTHER;,
SIGNATURE;
DATE;
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