2003, 09-04 Permit App: BLD-03-02394 Egress Window1
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San' ne
#Valley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
19707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
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STREET ADDRESS: .'La0 0*7
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
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DIIUILIN:NG PERMIT . 0 CHANGE IN USE ®GRADING ® MANUFACTURED HOME
®RELOCATION
D SIGN ® TENANT
(3-OT'HJ;R
OWNER / APPLICANT INFORMATION
-® OWNER: giAALBSc CAAtmeAiNis K ® APPLICANT:
PHONE: 'Z.& G t 5 ) FAX: PHONE: FAX:
ADDRESS: )3 0 ( I CA -Tek AO 0 ADDRESS:
CITY,STATE, ZIP
°CONTRACTOR: ® ARCHITECT:
PHONE: FAX: PHONE:
ADDRESS: ADDRESS:
CITY,. STATE, ZIP
CITY, STATE, ZIP
FAX:
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # CONTACT:
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COST OF PROJECT: 6 VV
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
MAIN FLOOR SQ FT:
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
DATE:
METHOD OF PAYMENT.'
CASH CHECK
STAFF:
VISA
SANKCARD t EXPIRES:
AUTHOR/ZED SIGNATURE.
V/N#
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