2003, 10-03 Permit App: BLD-03-02665 Reroof10/11/2003 15:04 SPOKANE LU BU1Lll1NU 2S LUllt tNrur VCCODUJr
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PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address: t 1 L r
Assessors Tax Parcel Nurnber(s):
Legal Desertion:
0
oject Description:
Permit
A L 3 .S Z— d •-• kr
Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
Depaztment. Jse'Only • ' :. : .
Building height to peak
Mince
Ire
'Cur Uuu4ct/P.n, t_
' .
Sever D:sirici/Por,e;^nr .
RoAi3'ivithh:
S�4backr' .
w5sortc , '
.'
• IA"
Rear.
..
1?igir
.'•� -
.'.Sehbol thstace' ".
- " '
r, .. Distdat
Lay. State. Zip
OWNER/APPLICANT INFORMATION
121 Indieatt ubo tiwutd b: twftaded rsgordi, t1z+rDroiert
❑ Cat'ncr. k i on
YA
Building height to peak
Mince
Ire
0 Applicant
Phone:
Fax:
Madir ; WMr
Total habitable space
♦
Mailios Addles,,:
Occupancy group
City, State, Zip
Garage sq. fr..
V
Lay. State. Zip
/kat source (electric, gas, etc.)
❑ eo tra tar Is
v
Phone
..-4,,.-
q\xt»tect/lint}o«t
Phone
P'ae
Mvling address
Ma+7irg addrea
C. State Gip
St1 lam,4....,,
5\911)—
Coy. State Zip
WA State ontractor license xt
Comet name
a
fd,30 !
PRO CT INFORMATION
SEP 28 2003 16:08
PAGE.02
Building height to peak
# of stories
Main floor sq. ft.
Unhnishcd basement sq. ft.
Dimensions
Total habitable space
2na floor sq. ft.
kin+shed basement sq ft.
Occupancy group
Construction type
Garage sq. fr..
Dec{: sy. ft.
(Cost of projoct
/kat source (electric, gas, etc.)
SEP 28 2003 16:08
PAGE.02