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2003, 10-14 Permit App: BLD-03-02777 Reroof1 Supokane valley 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: l-1 L3 n ' Lo c �d • iCLU H S ' Valle4.\ i Wes '192 b ASSESSOR'S TAX PARCEL NUMBER(S): u U LEGAL DISCRIPTION: PERMIT DESCRIPTION: QF _Z o- e!(' P k,14S'it—kirk% I x O BUILDING PERMIT ID CHANGE IN USE 0 GRADING ®RELOCATION ®SIGN QTENANT MANUFACTURED HOME ® OTHER 1 1 OWNER / APPLICANT INFORMATION 1 ® OWNER: 2:%\ - Ski (1,1 d' `a \ l'elr_ PHONE 17jf) 1 C124-7_23 ( FAX:7 ADDRESS: 41 i Yl. LQn-v 1�u• SCYnnP iblfie x �I���['.,.C�n ,STATE, ZIP 7` °CONTRACTOR: ISN�n ag, nub I �Q/\) PHONE: FAX: ADDRESS: CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # • APPLICANT: PHONE: ,L' ADDRESS: 2110 ® ARCHITECT: PHONE: ADDRESS: FAX: CITY, STATE, ZIP FAX: CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT:I/1000 30% SLOPES ON PROPERTY: BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: BUILDING DIMENSIONS: CONSTRUCTION TYPE: NUMBER OF STORIES: NUMBER of BEDROOMS: STRUCTURES ON PROPERTY: CRITICAL AREAS: MAIN FLOOR SQ FT: 2N0 FLOOR SQ FT: UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: METHOD OF PAYMENT: CASH CHECK VISA BANKCARD A,• EXPIRES: AUTHORIZED SIGNATURE' VIN#