2003, 10-13 Permit App: BLD-03-02757 Siding, Windows1
1
*kat'
valley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BU/LD/NG DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: I"log A), `C(,j,(i'(,u 'Co(
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: feri(((i//G,l s;cil -/ 4,Na 9 M./ /Ed .4's
JJ
It.
BUILDING PERMIT 0 CHANGE IN USE ® GRADING 0 MANITFACTURED HOME
®RELOCATION
® SIGN- ®TENANT
®O PHER
1
OWNER / APPLICANT INFORMATION
1
® OWNER: Gklit) IjCrd m
c17�/ -112/2_
/ APPLICANT:
PHONE: /('/7//j2I L FAX: PHONE:
ADDRESS: /ijO 3 Al, Caw' i £ C
FAX:
ADDRESS:
Porker
p CIITY,STATE, ZIP CITY, STATE, ZIP
CONTRACTOR: fee Porker /) Grk-eer Y%�I 2(lit /II ���U(® ARCHITECT:
PHONE:CSD'1�/07)0—t"17�p/"I �( FAX: (57 )Lh3J7J'f4I PHONE: FAX:
ADDRESS: LZ312-) C r /IQ Ci /-fq��/ 144 ADDRESS:
r���rr
CITY, STATE, ZIP kq.4 N CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # PIA C� (7 /L7
CONTACT:
PERMIT/BUILDING INFORMATION
COST OFPROJECT:Bi /3(14. J0
BUILDING HEIGHT TO PEAK:
BUILDING DIMENSIONS:
NUMBER OF STORIES:
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
1
MAIN FLOOR SQ FT:
2ND FLOOR SQ FT:
UNFIN BASEMENT:
STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
II DATE:
METHOD OF PAYMENT:
STAFF:
® ® ®
CASH CHECK
VISA
BANKCARD#; EXPIRES: V/N#
AUTHOR/ZED SIGNATURE:
11