2004, 05-10 Permit App: BLD-04-04310 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
Street Address: i/3 /a f. /L/s at •
Assessor's Tax Parcel Number(s):
Legal Description: '/
PERMIT DESCRIPTION: , oo-F C ciod er
Building Permit
Relocation
❑ Change in Use [ 1 Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: egret, Sko404
Phone: 9ay-53oy Fax: 9n -9/2C,
Address:Cit_/13/,.? f 44/9
Gbl�•
/4/%, 4/A 97-04-7.00Ci State Zip Code
❑ Contractor: 91.✓r12A
Phone: Fax:
Address:
City
State Zip Code
WA State Contractor License #:
Applicant: siri..Q._
Phone:
Address:
Fax:
City
State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: i
tr/ Roo —
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?