2005, 06-21 Permit App: 05002103 Roof CoverJUN 20 2005 13:03 FR 5F UKHNt 5 I Kut i urcta
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BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Develop a dD t
g Div s artmn
n
19707E Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 5,2 / E V�4 Spa's' `'u�---
Assessors Tax Parcel Number(s):
116 .(311
Legal Description:125113-)
PERMIT DESCRIPTION: pg. si- Ae_ai is 614 444O -To •� dot
Er Building Permit ❑ Change in Use 0 Grading 0 Manufactured Home
❑ Relocation 0 Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
® Owner. Rs G.E,L Do Ai 1 it,
Phone: C2.4 - Oa.- Fax:
Address: Said . '. Eba 1ta-LDV
S/�lGa-u�
City State Zip Code
53 Contractor Spa Sr A - xis
Phone: q? --7 .oL ss Fax: 0x7-'441-
Address:
7 '4 i. -
Address: S /a Ali . r1
S pvbx. v*: k)A- frfuK
City • State Zip Code
' WA State Contractor License #: Km 1124,eG
Spokane Valley Bus. Liscense #: 6 a 247
® Applicant: See /4-W cr,-r tv 5
Phone: 01- e 4 s - Fax: 1.27 -4042
Address: Sid .v. Ptu t tA-Q g4
at,
g.. -,vE k'smte f 2-o de
0 Architect:
Phone: Fax:
Address:
City
State Z1p Code
Contact: (26 5 t o w t 3
Contact /fir ( t&Wt
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK ,
/7
DIMENSIONS:
«'/kkw Ta
T # OF STORIES:
UNFIN BASEMENT SQ. FTG:
MAIN FLOOR TO SQ. FTG:
0" FLOOR SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CO TRUCT1ON TYPE:
Voss 3-mz
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ONSITE SEPTIC
SYSTEM?
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JUN 1? 2005 12:13 FR SPOKANE STRUCTURES
SSPOKANE
TRUCTURES, INC.
ES : 60 Sbbc ec rn ii
5099274062 TO 4777196 P.02/02
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This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions, curb lines, structures and easements
have been identified. Also indicated are w ds,
bodies of w steep slopes al ideas.
Signed. 'cam. `2,4
6 -- 21 CSS
Date:
E0/Z0 39tid
Eice
ZONE
ROAD WIDTN
• • FRONT
COMMS
REVIEWED
/e
510 N. MULLAN RD. • SPOKANE, WA 99206 • (509) 927-0555
TOLL FREE - 1-800-735-6347 FAX (509) 927-4062
www.spokanestructures.com
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