2004, 05-14 Permit App: BLD-04-04351 Carport1
SiMane
Walley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
19707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
17011 (44-)4i>i LN fr
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: ) p X L' yj _Cl r P
.aIPUILDING PERMIT
QRELOCATION
O CHANGE IN USE 0 GRADING 0 MANUFACTURED HOME
O SIGN ® TENANT
® OTHER
OWNER / APPLICANT INFORMATION
1
r
®OWNER:CTLct C �<SVI,P jc�QJ�I �9 APPLICANT: ��J tj'Z-7ryL��� �.Jfi�ly ►^'�,i/` RD Du al
PHONE: vr p (� I[J FAX: _ 1 PHONE: 5/D—L�-_ ^Lr (0104910/�FA�X: 1-1407- `' 1 C1
ADDRESS: n `l /`� Ayl'Wl La�
ITY,STATE, ZIP / CITY, STATE, ZIP
CONTRACTOR: - ® ARCHITECT:
PHONE:
ADDRESS: ADDRESS:
CITY, STATE, ZIP
121.143 bt?
FAX:
PHONE: FAX:
WA ST CONTRACTOR LICENSE k eft
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 4'liZ
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
1
MAIN FLOOR SQ FT:
2N° FLOOR SQ FT:
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:
0000 GRA Qv 1-111U E.
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