2005, 04-01 Permit App: 05001049 ReroofBUILDING 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:
C.?
Assessor's Tax Parcel Number(s):
Legal: Description: Prot) .F Lf O alt
PERMIT DESCRIPTION:
fl Building Permit
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: Lc" Lars ❑ Applicant:
Phone: 9 - o Sa Fax: Phone: Fax:
Address: 35 -a -I 5-, Address:
City State Zip Code City State Zip Code
El Contractor: 4C Fo LOA dLt p t,/ Roc f wv ct(' ❑ Architect:
Phone: 9.28 wpg Fax: Phone: Fax:
Address: 1.26 H i 110,10 Fe4c1 1)1(- Address:
1-41a- Icktm
City State Zip Code City State Zip Code
WA State Contractor License #: ArrFRNgoo &ibtJ Contact: • 5 -/co F L`er)
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: Q /
DIMENSIONS:
# OF STORIES:
MAIN FLOOR.TO SQ_ FTG:.. •
•.2Nu..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:
-il oo, ,;;, ..
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC.
SYSTEM? /
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