2004, 02-03 Permit App: BLD-04-03492 Garage Additionw�crrrrc
Valley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BU/LD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
`%3z1 5 f rLjL D
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
BUILDING PERMIT 0 CHANGE IN USE 0 GRADING
®RELOCATION ®SIGN ®TENANT
® MANUFACTURED HOME
® OTHER
OWNER / APPLICANT INFORMATION
®OWNER: DIEM g FLI err
PHONE: J4,115- 32 5'3 FAX:
ADDRESS: 7 3 7 t SI ,t4 -R a RD
CITY,STATE, ZIP
®CONTRACTOR: WIbr1r- ?IR 077! tS /ZS- SUL/.ROcsoi S® ARCHITECT.:
APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
PHONE: 9z7—//9U FAX:
ADDRESS: azo SNL- #/#.J
92-7 - /3 a/ PHONE: FAX:
WA ST CONTRACTOR LICENSE #
SrOIIA L)C ✓/} u -!C P ADDRESS:
C TY, STATE, ZIP q 37
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: /Z
BUILDING DIMENSIONS: /tope
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
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 SQ FT:
2N0 FLOOR SQ FT:
UNPIN BASEMENT:
FINISHED BASEMENT:
GARAGE: 3 5.2_
COVERED DECK:
DECK: -
• REVIEWED FOR CODE COMPLIANCE
i'sPorce,LLEI BUILDING DIVE Id
al DY Zlh
LUk✓/7E 1/IA/U/