2004, 04-05 Permit App: 05001236 Insurance Reconstruction04/05/2005 14:09 5093284772
*lane
0 Valley
(R4R tt 46151
Al GENERAL CONT PAGE 02
05-t23G
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
,0$05
REQUIRED SITE INFORMATION
Street Address: / 33i5- S LCC Gi/ciJ
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
g Building Permit
❑ Relocation
)f 5C.v-Gcn cp /2e .c_ ,- s / t€ tt (J
GncL /2oof') — '2 Lo55•60
❑ Change in se ❑ Grading
D Tenant Improvement ❑ Fire Safety
it73-
( ircifyin j , P/umbin i
D Manufactured Home
D Other
OWNER/APPLICANT INFORMATION
4(1 Owner: fe(ma LI Net cdd
Phone:811 `A4LFax:
Address:133)5 E. Ca+alctv
City. -590 Vatic/State: W4. Zip:tj9tiC'
$� Contractor: j--1Geieral +tocfors
Phone:323 3o5y Fax: 32E- y n ria
Address: (o JiO rJ Hot,t23.32
City:pu State:Wp Zip:99Zo3
WA State Contractor License #:
❑ Applicant:
Phone: Fax:
Address:
City: State: Zip:
❑ Architect:
Phone: Fax:
Address:
City: State: Zip:
Contact:
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2NO FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
in.SU(anel &r_a7S #YU,c h o -i
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
RPR 05 2005 15:17
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04/05/2005 14:09 5093284772
Al GENERAL CONT PAGE 01
First General Services A-1 General Contractors, Inc.
Insurance Repair Specialists
N. 6410 Monroe, Spokane, Washington 99208 • (509) 328-3054
Contractors # AIGENCJO9ID)
DATE: 4- S- OS—
NUMBER
SNUMBER OF PAGES: 3 (including cover page)
FAX TO:
ATTN .
FROM:
0.47 nr vat
FAX #: 509-328-4772
REF. TO: N'2cl h'71,b Tul
NOTES: 133/s t Cala/r{..) ,
t
APR 05 2005 15:16
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