2003, 09-03 Permit App: BLD-03-02369 RemodelSPoxNCouNrY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: c°
E
X12,rt La vie
Assessor's Tax Parcel Number(s): 33 @
Legal Description:
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Project Description: V1 >1 t S s..erv‘24/k, di20o. 1 Ee-tAitt Oet"`^.
10) 11-- w t �'L 54
126v
71 Building Permit
17 Change in Use
O Grading
Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
17 Other
Department Use
Phone: a2O (j (p(6,
Fax
❑ Applicant
Phone: :
Fax:
Mailing Address:
(li(o q E V-10(-2 C
(c:vt.___
Mailing Address:
water D1st ct/Pu�eyoc . ,
S wen
tl
par
7
tut .t
t
FReat
School District
City, State Zip
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted re2ardin2 this broiect
ltd Owner.
KICIJ n yl\er-t
Phone: a2O (j (p(6,
Fax
❑ Applicant
Phone: :
Fax:
Mailing Address:
(li(o q E V-10(-2 C
(c:vt.___
Mailing Address:
City, State, Zip
SPO kehi E_ ors,
1 q a ( 2---
City, State, Zip
❑ Contractor
Phone
Fax
In Architect/Engineer
Phone
Fax
Mailing address
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
Building height to peak
# of stories
PRO ECT INFORMATION
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
Heat source (electric, gas, etc.)
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