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2004, 07-28 Permit App: BLD-04-07180 ReroofBUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION N. Street Addres: // ! ,E; '/ifril/e,,,2 Assessor's Tax Parcel Number(s): Legal Description: --PERMIT DESCRIPTION: r g rJ4'S RP L/0�,� Building Permit ❑ Change in Use El Grading ❑ Manufactured Home Relocation ❑ Tenant Improvement ❑ Fire Safety D Other OWNER/APPLICANT INFORMATION ❑ Owner: (a ur)( bac' 6 Sacs Phone: gqi- 6_737 Fax: Address: /g/q L , 57&,2Vie,{, ,cc/ e City El Applicant: Phone: Address: Fax: State Zip Code City State Zip Code ❑ Contractor: ILaV_7L Pal< tee, � ❑ Architect: Phone: ,72_Sr423 y Fax: Phone: Fax: Address: (v, i qc - N- iv, ( 1„ el Address: quos City State Zip Code City - State Zip Code WA State Contractor License #: #02.-/-8"-o ?a n S Contact: i97 , 7 PERMIT/BUILDING INFORMATION HEIGHT TO PEAKa© / DIMENSIONS: # OF STORIES: MAIN FLOOR TO SQ. FTG: 2"'} FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECKICOV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROACT: p,C(.)0 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM?