2004, 03-08 Permit App: BLD-04-03713 Change of UseSporn' 'lane
jUalley
BUILDING 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:
6 s — Ka cr E
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: C D E r-±"4 L Do -to I , -1'10
❑ Building Permit
Relocation
X00
Change in Use n Grading
Tenant Improvement 1 1 Fire Safety
11
Manufactured Home
❑ Other
OWNER/APPLICANT INFORMATION
Owner: 4-4r TRa NC)
Phone: cos 7 y .1r ea Fax: -
Address: 5-2--/-
p4_S 5'5 i ..
City
Applicant:
Phone:
Address:
Fax:
State Zip Code City
State Zip Code
❑ Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City
State
WA State Contractor License #:
Zip Code
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"ll 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:
30% SLOPES ON. PROPERTY:
SEWER OR ON-SITE SEPTIC
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