2003, 08-19 Permit App: BLD-03-02268 Egress Window*Van'
aosiValley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: a_ / 8,65-
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
O BUILDING PERMIT
▪ RELOCATION
® CHANGE IN USE ® GRADING 0 MANUFACTURED HOME
® SIGN Q TENANT
Q OTHER
OWNER / APPLICANT INFORMATION
® OWNER: Q4C/�Avizwy
PHONE: 9 VT C /�FAXX: -yam ,,[
ADDRESS: f P OBJ !--e /LCL e//i(.J`�
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°CONTRACTOR: 3 1 qf
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PHONE:17?-11575-
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ADDRESS: AlGV vGi� Akee y
® APPLICANT: St
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PHONE: FAX:
ADDRESS: Ar -3.3 'y
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ARCHITECT:
PHONE:
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CITY, STATE, P CITY, STATE, ZIP
FAX:
WA ST CONTRACTOR LICENSE #
CONTACT:
1
PERMIT/BUILDING INFORMATION
COST OF PROJECT: /�9,
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
' NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
1
3O SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
OCCUPANCY GROUP: 2ND FLOOR SQ FT:
CONSTRUCTION TYPE: UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: GARAGE:
CURRENT PROPERTY SIZE: COVERED DECK:
CURRENT PROPERTY USE: DECK:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA: