2004, 03-02 Permit App: BLD-04-03655 Inground PoolPERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509,686-0036 Fax: 15091688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: jq
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: ...i-oirr-o,dr? J m)h
DRUMM-NG PERMIT a CHANGE IN USE a GRADING
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OWNER / APPLICANT INFORMATION
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13 OWNER: 2- QAI y Gfr-eco
PHONE: ?0? 7— /8,R2 FAX:
ADDRESS: ...9.--71/ -5 &idly)) Sb4/o AskeK 404 999.* ADDRESS:
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bONTRACTOR: —/ General ro, 4t4, 47/1:0'r, CI
PHONE:i r -,;OP/ FAX: .^1f?"-* PHONE: FAX:
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CI APPLICANT:
PHONE: FAX:
ARCHITECT:
CITY, STATE, ZIP
ADDRESS:
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1 CITY, STATE, ZIP
WA ST CONTRACTOR UCENSE # A/6"Nci 07/0/
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFOR
AT ON
COST OF PROJECT:
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:
CURRENT PROPERTY USE:
COVERED DECK:
DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE:
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IMPERVIOUS SURFACE AREA:
ADDRESS
ZONE
ROAD WIDTH
FRONT FLANKING
COMMENTS
REV EWED BY
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