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2004, 06-18 Permit App: BLD-04-04639 Garage0", Sfielane ,solY og-gth 39 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: a //S� N- 17.2,444,4 33i?/•sPoi Assessor's Tax Parcel Number(s): 771acie 20 7 al liack?JAdeyur, Add. ,;.#, ASze6,( ,OhM'tattle/vv/wo, nm06le 10l4,445)"3`' pear' Legal Description: PERMIT DESCRIPTION: ryi Building Permit ❑ Change in Use 1 • Grading ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Manu altured Home ❑ Other OWNER/APPLICANT INFORMATION c8 Owner: Z. 4. ttei vnispN ❑ Applicant: Phone: 9z2-9172- Fax: Phone: Fax: Address: Zyt,S- 4. EL17-41.ETll Address: oicite rV,sL ' 4.-)4.•117--itCity JJ State Zip Code City State Zip Code }I Contractor:27 Ctrl olt ❑ Architect: Phone: 7,,c -2;5,, Fax: 54-nnj Phone: Fax: Address: D, 60x 9 Address: Rtpu (Vic-14)4yts/G4 • City 1 State Zip Code City WA State Contractor License #. 7 Z' ,,,,,T!' we /pi,/ Contact: oma State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK , Pi -.pre- I / ei„'ic DIMENSIONS: a iea4 # OF STORIES: l MAIN FLOOR TO SQ. FTG: hA 2""' FLOOR SQ. F G ��R UNFIN BASEMENTQ. FTG: r‘. 4 FINISHED BASEMENT SQ. FTG: ✓`n GARAGE SQ. FTG: �` DECKlCOV. PATIOS . FTG: VI� a s� OCCUPANCY GROUP: A/A CONSTRUCTION TYPE: C-5 A,,,.;• i t HEAT SOURCE: 6/4- # OF BEDROOMS: •(1,4 TOTAL HABI ABLE SPACE: AS IMPERVIOUS SURFACE AREA: COA. OF PROJECT' /46 7 v 30% SLO ON PROPERTY: 4D SEWER OR ON-SITESEPTIC MP** SYSTEM? "/4 • • 8' w/FLC S OS -6 1 --- EL J Z A Bi i I4 ST 4— 13 Z 2yZ%4 T11 2y' .16.I1„Ei.on gccCSS 72' ADDRESS 41 ZONE `,l t ROAD WIDTH FRONT FLANKING COMMENTS ) /; REVIEWED BY �'1 t1 -7-`?f-ticu 5 LOT s:2-g- IZ G' X 3© ! I /10 -7 88 s7 \fr 72 '`) E +-It) MIS 01111 is ,ohm itted ter the propose of obt e ming permit end isa true and coma refest ot trpotlet. ► property linesions, curb fines, sttuct and easements have"dentitied. Also indicated arewetlands. bodies"*star, stoop other crowd nds• Signed: , -terra Dd1A /9o2-' S p4Tio 2y' .1t05 , 2 24, 40 12 a 9r