2005, 04-12 Permit App: 05001151 ReroofFROM : ALPINE CONSTRUCTION r HA NU. •UV 7i�OJJr�Y
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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: 609 688-0036 Fax: 509)688-0037
REQUIRED SITE1NFORMATION
STREET ADDRESS: / /
/
4,,2-('J Eco
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL OISCRIPTION:
PERMIT DESCRIPTION: T EV'n- OFF
Xi-BUILDING.PER IIT
DRELOCATION gt SIGN
CI CHANGE IN USE
GRADVG MANUFACTURED tLOML
aTENAN'T Q OTHER
OWNER /APPLICANT INFORMATION
0 OWNER:
PHONE FAX:
ADDRESS:
APPUCANT:
PHONE: FAX:
ADDRESS:
cITY,STATE, ZIP
I] ARCHITECT:
PCbNTRACTOR:APa LaaSTA-4.>
PHONE:4,4 6099
FAX: q Y 53 • S-45-04
ADDRESS:44.L q 4 1. 1.E Aane- on , ¥\ 1-1.1
CITY,, STATE, ZIP
WA ST CONTRACTOR UCENSE # /4"1," L fl S -`44141 CONTACT:
CITY, STATE, ZIP
PHONE:
ADDRESS:
FAX:
ft -,us
/LAPPN
CITY, STATE, ZIP
PERMIT/BUILDING'INFORMATION
COST OF PROJECT: *
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
APR 08 2005 08:05
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:,
CONSTRUCTION. TYPE:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SO FT:_,
2N0 FLOOR SQ FT: _
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK:
5094485504 PAGE.01