2004, 02-11 Permit App: BLD-04-03534 Finish BasementOkL- 6
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
1
STREET ADDRESS: /4If‘i2 C 00-)
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
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PERMIT DESCRIPTION: EiN CT CFF 1LS CM EJ r
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OWNER / APPLICANT INFORMATION
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OWNER: j OS effi u otEA,-)
[3 APPLICANT:
PHONE: 539- LiCSL4 FAX: PHONE: FAX:
ADDRESS: I 4-1- 2.1L C40.)J ni Ave/ Sib KAivc: t/14._ c/i LAADDRESS:
CITY,STATE, ZIP 9 ?2i
°CONTRACTOR: 1:1ARCHITECT:
PHONE: FAX: PHONE: FAX:
CITY, STATE, ZIP
ADDRESS: ADDRESS:
CITY, STATE, ZIP
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: :724 LY) 30% SLOPES ON PROPERTY: MAIN FLOOR SQ FT: /-31/Q
• BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS: CONSTRUCTION TYPE:
OCCUPANCY GROUP:
2N0 FLOOR SQ FT:
UNFIN BASEMENT: (/ 0 0
•NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: •COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: DECK:
REAR SETBACK: • CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA: