2004, 08-26 Permit App: BLD-04-07487 Reroof`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 •
StreetAddrees: I/7,W W G"MCA A20/
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: tre goof).Qj✓o( LgW
9 Building Permit 9 Change in Use
9 Relocation9 Grading ❑Manufactured Home
9 Tenant Improvement 9 Fire Safety 9 Other
OWNER/APPLICANT INFORMATION
9 Owner: �Xyr%S 7 r4 4' ❑ Applicant:
Phone: c', yyrrg Fax: Phone: Fax:
Address: Gire.I - Address:
\�p F e t. , r tc-) sib
r state Zip Code City State Zip Code
9 Contractor: 19MJ.t%2 ❑ Architect:
Phone: Fax: Phone: Fax:
Address:
Address:
City State Zip Code City - State Zip Code
WA State Contractor License #: Contact:
- PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ: FTG:
UNFIN BASEMENT SO. 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:F/jrr 0'0
%)
3o% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? /