2004, 08-17 Permit App: BLD-04-07385 Tear Off, 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 •
Street Address: it -10a J Labutt (4.
Assessor's Tax Parcel Number(s):
Legal Description: rn
PERMIT DESCRIPTION: TPnr C)R- rNrs(r3
❑ Building Permit
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: (7/en t3orclen
Phone: qai(-q /2_ Fax: —
Address:
❑ Applicant:
Phone: Fax:
Address:
City State Zip Code City , State Zip Code
❑ Contractor: • 0,Y9&lreaoyi ❑ Architect:
Phone: 9QC/-G79 S Fax: Phone: Fax:
Address: i9 .5 /74 . Address:
City State Zip Code City -
WA State Contractor License #: Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ: FTG:
Zra' 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:s��( p4
30°k SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?