2003, 11-04 Permit App: BLD-03-02980 Shop' °
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206..,
Phone: (509)685-0036 Fax: (509)655-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: / 1l) v 3
Oeente/-
ASSESSOR'S TAX PARCEL NUMBER(S):
YS -/(102- . / l 3
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
11(1. -DING PERMIT . 17 CHANGE IN USE . CI GRADING
}RELOCATION ®-SIGN lTENANT
CI MANUFACTURED HOME
0 OILIER...
OWNER / APPLICANT INFORMATIONt
OWNER: I2-ek7
�7�//ONS'
PHONE: /51 1�7� 53 ¢AX: 79,T PHONE:
ADDRESS: /'(,/%/3 cf
APPLICANT:
ADDRESS:
C�—CITY,SSTATE, ZIP
CONTRACTOR: 7,�, /��� 3/ /TY(' etj[ j ARCHITECT:
PHONE: (220-/-3%' ,F/AX: S�-(Y"-1/7��7
ADDRESS: .2.4/036OJ .J, � ✓,pr (G. a4 ADDRESS:
CITY,STATE, ZIP 93 2
Sc
6 FAX:
• CITY, STATE, ZIP
PHONE:
WA ST CONTRACTOR LICENSE #
FAX:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: /S -00C
BUILDING HEIGHT TO PEAK: /ei
BUILDING DIMENSIONS3d YC ( 0
'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:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: GARAGE:
CURRENT PROPERTY SIZE: . COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE: -
UNFIN BASEMENT:
IMPERVIOUS SURFACE AREA:
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