2005, 07-13 Permit App: 05002375 Tear Off, Reroof•
Wane
„goo/Valley
BUILDING 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: /SD'a
Broad Ate_
Assessor's Tax Parcel Number(s):
Legal Description: 1
PERMIT DESCRIPTION: Re - rpa /DL1S--P.
Building Permit
Relocation
❑ Change in Use ❑ Grading
❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: % ,e5)rr7 >,P_
Phone: 29,9-31,S" Fax:
Address: /6,04,9E Brcvd tiv'e
44.e vQ1/G, y eeoi cp9)(a
Ci State Zip Code
❑ Applicant:
Phone:
Address:
Fax:
City
State Zip Code
❑ Contractor: 0 Architect:
Phone: Fax: Phone: Fax:
Address:
Address:
City State Zip Code City State Zip Code
• WA State Contractor License #: Contact:
Spokane Valley Bus. Liscense #: Contact:
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: 01200
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?