2004, 06-30 Permit App: BLD-04-04806 Tear Off, Reroof0
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:
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: (OCID
Building Permit 0 Change in Use D Grading
O Relocation n Tenant Improvement E] Fire Safety
0 Manufactured Home
0 Other
Wre
OWNER/APPLICANT INFORMATION
O Owner:
Phone:
Address:
Fax:
0 Applicant:
Phone:
Address:
Fax:
City State Zip Code City State Zip Code
Contractor: ije 0 Architect:
Phone: .3;?6, 6t9b6 Fax: 3 /6 S7 Phone: Fax:
Address: 1 g / g (,v, Aion_o-- Address:
9? -45"-- 41/6?—
State Zip Code
City
State
WA State Contractor License #: g „r,c_.9(-2(;VContact:
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,
4/9 7-2 . "11
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?