2003, 09-04 Permit App: BLD-03-02380 Pole BldgS ieskan e�
Walley
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:
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
P7P-
0473.:
P-
c 7 °227
PERMIT DESCRIPTION: 4 ' X o Y 121
EIHUTLDING PERMIT 0 CHANGE IN USE 0 GRADING ® MANUFACTURED HOME
® SIGN Q TENANT
®RELOCATION
EJ OTHER
OWNER / APPLICANT INFORMATION
® OWNER: E/,dere /?, J')?& W
PHONE: 9;4fj ny / FAX: PHONE:
ADDRESS:
• CITY, STATE, ZIP
®
-3-; APPLICANT: i(l V COQ
ADDRESS:
/t CI�TY,STATE, ZIP
/r
®CONTRACTOR: `alK S/?O`
3 df2l/zhtC- 77,74 ARCHITECT:
PHONE: 7-74 -15-3-7 FAX: / PHONE:
ADDRESS: 5 - Liao wgie hC�R a5 I NALLstb ADDRESS'
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # e(Dc)!�. V 7 e *e'nc %70
FAX:
FAX:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
30% SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK: 7 6 OCCUPANCY GROUP.
BUILDING DIMENSIONS: 07Y)(3 -O CONSTRUCTION TYPE:
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:
MAIN FLOOR SQ FT:
2ND FLOOR SQ FT:
UNFIN BASEMENT:
. � Job_
COOK BROS. STEEL BUILDINGS Sheet#
a�-0O Wide River Road
Post Falls, ID 83854
(509) 924-1557 8 (208) 777-1197
11/4 ev 9 SrJ�/
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Date
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