2004, 06-08 Permit App: BLD-04-04534 RemodelSPOKE COUNTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DEPARTMENT OF BUILDING AND PLANNING
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description: 2 424`4 z-zr2• �c,2 =���
❑ Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
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Phone:
Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:
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Mailing Address:
City, State, Zip
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City, State, Zip
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Road width
❑ Architect/Engineer
Setbacks
Mailing address
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OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted reeardine this project
❑ Owner. �f/f
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Phone:
Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:
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Mailing Address:
City, State, Zip
City, State, Zip
0 Contractorra/�`"''I
%% tit i t `
Phone
Fax
❑ Architect/Engineer
Phone
Fax
Mailing address
:2'4;Z) , Lt).
Mailing address
Mailing
City, State Zip
14"."4
City, State Zip
\VA State ontractor license #
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Contact name:
PROJECT INFORMATION
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2nd floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
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Heat source (electric, gas, etc.)
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