2004, 03-23 Permit App: BLD-2004-03854 ReroofSpokane
Valley
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:
709 1`e1
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: fn1 I+
❑ Building Permit
❑ Relocation
❑ Change in Use ❑ Grading
❑ Tenant Improvement ❑ Fire Safety
❑ Manufactured Home
❑ Other
OWNER/APPLICANT INFORMATION
Owner:.
Phone:
Address:
VAN L
City
b SSI
V IIFax:
State
❑ Contractor: N•Peff101tii
Phone: Fax:
Address: 2,14 3 I ocil
SpOkoate °1—W4
City:
❑ Applicant:
Phone:
Address:
Fax:
(ZZiip Code City
�-p(�4; it ❑ Architect: •
S.3(1-34bb Phone: Fax:
Address:
State Zip Code
State
991,1_
ie
City
State
WA State Contractor License #: Contact:
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2NO 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 PROJECTl
MOO
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?