2003, 09-15 Permit App: BLD-03-02478 Shop1
1
3X)
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11 707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
/02 Q s-�I '/%4nfl e -
ASSESSOR'S TAX PARCEL NUMBER(S):
1 ,n
LEGAL DISCRIPTION: 'X/•[
ys/S(. lQ24
6Pg2-�so�
PERMIT DESCRIPTION: 7-36 %E a /cam
BUILDING PERMIT ® CHANGE IN USE
0 LOCATION
® SIGN
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GRADING
TENANT
O MANUFACTURED HOME
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1
OWNER / APPLICANT INFORMATION
1
®OWNER: Cel S tt.)A-/PF+C
PHONE:
92 Fit- 369? FAX:
ADDRESS: /LO r ..7219,1151e, SPo4a,j ✓ilii•
CITY,STATE, ZIP
/®
CONTRACTOR: /27iriE - 2�/CyS /-
PHONE:
9K/- S.
/q2 FAX: Z' gS72_
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ADDRESS: ?a - gJ X 2G% C4/7 /F /Ws, ! �4
CITY, STATE, 21 P9 Fe 24
WA ST CONTRACTOR LICENSE # F2Ag;c C 0/ 34' Al
APPLICANT: /4/74r1
PHONE: 987- S6 7 % FAX:
ADDRESS:
/ / /� CITY, STATE, ZIP
ARCHITECT: /4JR6&
M //S NC7 iAJFEL
PHONE: 94/2 - 6"er6 FAX: J/l
ADDRESS: 2,, 3 if5, al " 4,-fre 7'
CITY, STATE, ZIP
CONTACT: AY R -J
PERMIT/BUILDING INFORMATION
COST OF PROJEWT: 7 S'o a
30% SLOPES ON PROPERTY:
1
MAIN FLOOR 5Q FT:
BUILDING HEIGHT TO PEAK: /3-4 OCCUPANCY GROUP: 2N0 FLOOR SQ FT:
BUILDING DIMENSIONS: 2 S'X 2q C 7(eCONSTRUCTION TYPE: AZ / An A•fe UNFIN BASEMENT:
NUMBER OF STORIES: / STRUCTURES ON PROPERTY: Psi L it'--71
FINISHED BASEMENT:
GARAGE:
NUMBER of BEDROOMS: 5/
II DATE:
CRITICAL AREAS: 006.1%-$E •
II STAFF:
METHOD OF PAYMENT:
CASH CHECK
BANKCARD #,•
AUTHORIZED SIGNATURE.
0
VISA
EXP/RES: VIN#
S/ILE. ?79 -ti
Gorzzpany aE Sp3L---A c. Inc
.A rr�zc°•rly SY�warY 7Yel'� of Spofccznr
818 W. RIVERSIDE
SPOKANE, WASHINGTON 99201
(509) 747-6426 - FAX: (509) 747-6827
This map is furnished for information and location purposes only.
Courtesy of: Pacific Northwest Title of Spokane
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[ Courtesy of: Stewart Title of Spokane, Inc.
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This map is furnished for information and location purposes only.
Courtesy of: Pacific Northwest Title of Spokane