2003, 08-26 Permit App: BLD-03-02326 Pole Bldgclaw all 10600r, N*416
moKan
4;o0vailey.
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUN/TYDEVE•LOPMENT
BU/LD/NG DIVISION
11707 East Sprague A ve Ste 906
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
I REQUIRED SITE INFORMATION li
STREET
ASSESSOR'S TAX PARCEL NUM
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
N'4, d
UI DING.PERMFr E3 CHANGE IN usE 3 GRADING MANUFACTURED _HOME
[}RELOCATION ®-SIGN 13 TENANT C[OTHER
ILS_ OWNER / APPLICANT INFORMATION 11
® OWNER S�/T A)4EG� � ✓ C t) 13
PHONE C�.�C� g� -/y',LF)AX:
ADDRESS
I
fro ZZ �A
ITY,S ATEp �%/7^�-Zf � � �
13PUAN� i
CONTRACTOR:��, f/�' N��d, v
PHONE: - --f6 / % FAX: 3--'k,2 zl<�'%
ADDRESS:o A X40 I
CITY,. STATE, ,ZIP
WA ST CONTRACTOR LICENSE #-=C�� * 970 Z fS
APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
ARCHITECT.:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:ZO-- -29
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS: -1 36
NUMBER OF STORIES: U
NUMBER of BEDROOMS: b
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SO FT:
2ND FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK:
APPROVED BY
/ fald Rd.
3y
W
ewcru r���
BUILDING /i .
SIZE
CONSTRUCTON l- - .%
FLOOR
STORIES I -
ROOMS AND GRADE 2
// O o
ROOMS -9 - I
FINISHED
07,
FLOORS '� 7
EXT. FEATURES
FOUNDATION C n yl
_
ROOF :7
,,//
FIREPLACE # 2 ^"' 7_ fC
STEMS FLUES
SECOND FLOOR
EX. CHIMNEY /'/
ROOMS
EXT. WALLS
CLASS
INT. WALLS
FLOOR
INT. TRIM f
SQ. FT.
PLUMBING FT, _-' i�.'7 .�.�•-:' .
EXT. PLUMBING IV
HEATING /
EXTRAS
CLASS -
SQ. FT. .''
PER �'-
NOTES
LIFE
% COMP. .J O
A.V.
-
'
YR. BLT.
L -
417, }
BUILDING
CONST. Y .
FDN.
FLOORS
EXT. WALLS i
ROOF iYi :7
ROOF CONST.
BASEMENT
PLUMBING
EXTRAS
CLASS
SQ. FT. n
PER
LIFE%
COMP. '
A.V. -
YR. BLT.
r -
BLDG. CLASS SQ. FT. PERM. LIFE
% COMP.
YR. BLT.
A,V,
I I
34 356 F1 PT OF 15
OPPORTUNITY
S8O'OF N320'OF Wk EXC ElOO'BEXC W20'
a=t_�
1 fa00
Load (Values
1Year I 3 IV 7dP
y
ear
..�:.a
lue 8 00