2003, 10-15 Permit App: BLD-03-02783 AdditionSpikan` ems`
,#ley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/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: 57 -EVE (Lt at 011q -L.:0
2912 S Fox
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: ADO 1�jq SpYn
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PERMIT DESCRIPTION: g,¢(L-y,,
$26LTILDING PERMIT
®RELOCATION
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® CHANGE IN USE ID GRADING 0 MANUFACTURED HOME
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OWNER / APPLICANT INFORMATION
® OWNER: STCJG `z. t,553/E //I -t 41)0"n #11-0 ® APPLICANT:
PHONE: / %�y' - (75? 7 FAX: PHONE: FAX:
ADDRESS: 202 S. Fos.. ADDRESS:
CITY,STATE, ZIP CITY, STATE, ZIP
®CONTRACTOR: OLSo. S /,w5»'r i i4 DIItZcTP k-.14-111® ARCHITECT:
PHONE: 2 ZC -3o4, `/ FAX: PHONE: FAX:
ADDRESS: 57/6e- I-y)C.. Pleb) An24"2"'¢'1 LS4/W ADDRESS:
CITY, STATE, ZIP cj,�s CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE ft O-SC v.-1 0 7 tg c CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 9,000 ,000
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK-
1
, 30% 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:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA: