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2004, 06-18 Permit App: BLD-04-04640 Pole BldgSpoken' ems'` ei.OUalley 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 REQUIRED SITE INFORMATION Street Address: Z'-) )C AI FL )7A1 S FTP -1 Assessor's Tax Parcel Number(s): 3SIz-1.570) Legal Description: iRR'T 207 of orzelrew 'O A'En4OE Ano:+ro.J, 4 r - PA -KT z eroeo y� VotvnnE m" PERMIT DESCRIPTION: Building Permit Relocation of fi-ilS , 9&- aq and zs ❑ Change in Use ❑ Grading ❑ Manufactured Home n Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner ?no R• mv&so4 Phone: qvz-yrj z Fax: Address: Z') /S 4. C-L17.w-u--o City ❑ Contractor: Phone: Address: State Applicant: Phone: Address: Fax: Zip Code City Fax: State Zip Code ❑ Architect: Phone: Fax: Address: City State Zip Code qty State Zip Code WA State Contractor License #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: J u / DIMENSIONS: ux t/ / ,29X # OF STORIES: MAIN FLOOR TO SQ. FTG; 2"" FLOOR SQ. FTG: © UNFIN BASEME (. FTG: FINISHED BASEMENTSQ. FTG: Y it /R GARAGE SQ. FTG: s7 1p DECK/COV. PATI SQ. FTG: /+ OCCUPANCY P: CONSTRUCTION TYPE: ?ate- gL0 6- , HEAT SOURCE: f N R # OF BEDROOMS: - / 1 TOTAL HABITABLE SCE: IMPERVIOUS SURF'AC,E AREA: COST OF PROJECT: 00 R f f 9 poo — 30°k SLOPES ON PROPERTY: A) / /`} .. - SEWER OR ON -ITE SEPTIC SYSTEM? /t i A o Si 5 i 4 E S61TIC IJ 1 �- 13z' zy' •IRIuEon Access 2I 1 ADDRESS ZONE rgf LiIs ROAD WIDTH FRONT COMMENTS CAI REVIEWED BY v1 FLANKING 1,oT s,zS 2-'X3o9 1 4 -to 7 58 s7 0 721 r`, of- sl -oust - S3 This site .gyp As being sequined ler the true and purpose obtainingilding permit and knowncorn property represq of the proposal• Alt lines!'! rii S}'ons, curb lines, structures and easements wetlands" lines( '�,i,,.,., dentilied. Also indicated fuel as. have slopes or mer, steep Sidles'; � L [ - t%T1 b Sig ; a /902-' s7 C arc PA7-10_ 241 1910551) rte 810• z9' T!I 7` •