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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? /