2003, 08-04 Permit App: BLD-03-02136 Egress Windowctn •
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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: g 6 / 0 iL -
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: c� res S S (`j I Act:, i.:
13 BUJ DING PERMIT D -CHANGE IN USE D GRADING D MANUFACTURED HOME
['RELOCATION D -SIGN ®-TENANT
D'OTHER.. •
OWNER / APPLICANT INFORMATION
® OWNER: /2? a (.LV' l Cf"_
LU o i
PHONE: In (FAX:
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ADDRESS:
CITY,STATE, ZIP
°CONTRACTOR: v ;70 )6.‹. J`) D ARCHITECT:
® APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
PHONE:')-- 7 - (-(2 70rr FAX: PHONE: , FAX:
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ADDRESS: 3O (Y A) r tl.y cr +-0y,CITY,.STATE, ZIP( y 2
WA ST CONTRACTOR LICENSE # S �) I N ►"1 1J 0 Ga 6 !3 C, CONTACT:
ADDRESS:
CITY, STATE, ZIP
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 3 0
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE: UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
CRITICAL AREAS: GARAGE:
MAIN FLOOR SQ FT:
2N0 FLOOR SQ FT:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
COVERED DECK:
DECK: