2003, 10-22 Permit App: BLD-03-02851 DeckSpee
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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
STREET ADDRESS:
/S3i( 4 , e4--T4r�0
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: ¶(
firBUILDING PERMIT ❑ CHANGE .IN USE • 0.GRADING
QRELOCATION DSIGN • El -TENANT
1
®MANUFACTURED HOME
D OTHER
OWNER / APPLICANT INFORMATION
1
® OWNER: A' a
PHONE: 4:72-9 41FAX:
ADDRESS: 75-3 �Z , (_Jt--%�-t_/JO
CITY,STATE, ZIP
®CONTRACTOR: /E' ! l/ne-7-Y
APPLICANT:
PHONE:2-fl
ADDRESS:
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34 FAX:
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CITY, STATE, ZIP
ARCHITECT:
PHONE: L%- 3 46 T FAX: PHONE:
g FAX:
ADDRESS:4*Z G 7.
6 ,`7n -t* -1&g' � 1' 1 Z ADDRESS:
CITY, STATE, STATE, P `
WA ST CONTRACTOR LICENSE # FC)03141-PVL CONTACT:
CITY, STATE, ZIP
PERMIT/BUILDING INFORMATION
COST OF PROJECtI 24" V 30%SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE: %t
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT:
1
2ND FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK: 15 -� '
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