2003, 09-03 Permit App: BLD-03-02371 Pole Bldg09/02/03 14:03 21909 927 4062
810164(211116.1re"
SPO. STRUCTURES
fit 002/005
D5-232(
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)6884037
REQUIREDRMATION
STREET ADDRESS: / /5 Al Af'Vovlata'' 2d. / 5 a/cam j 992.(G
ASSESSOR'S TAX PARCEL NUMBER($): 4157 /37.3 - 7lo a
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: /24.571- flea y,/e. (qui /d//r.,
S'BIJIT.DING PERMIT • 0 CHANGE IN USE 0 GRADING
QRELOCATION Ea SIGN CI -TENANT
O MANUFACTURED HOME
MOTHER.
II
OWNER / APPLICANT INFORMATION
11
El/OWNER:
PHONE:
h tc'a d lfcv744.4/4
927^ BZ Yf ''-
ADDRESS: 117 Al. Pl c//�� 6126.4 5 A
CITY,S ATE, ZIP
Itr
CONTRACTOR: 5,644110, - Shiv Vve.c • G 1]
PHONE: 5n9- 927-0655-FAx•Sol- 927- Yoco2_
ADDRESS:
CITY, STATE, ZIP
III/APPLICANT: ?G IGl &t2 9274-42441c1,4L tC .
PHONE: So9 t27-bLfr FAX• St'..nn -927'Y04.Z-
ADDRESS: 5/t3 41. G14.114r q SIOD 4-e
CITY, S ATE, ZIP
ARCHITECT
PHONE: FAX:
ADDRESS.
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE S CONTACT:
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: IS
BUILDING DIMENSIONS:301 CD ¥LO
NUMBER OF STORIES: I
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK;
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK;
AUG 30 2003 15:09
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:.
CONSTRUCTION TYPE: ilk FV4.€ yq
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE'
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT:
2Na FLOOR SQ FT
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK:
509 927 4062
PRGE.02
170
09/02/03 14:04 2Y509 927 4062 SPO.STRUCTURES
•
&--ASPOKANE
TRUCTURES, INC.
/L Pollokka a
003/005
Ps DeatOJ - flDP%t1b►JWI- Slit ttcrt.Lt S
CA-w130m tXCEEP aW S�. -\- .
/1
/74'p Iid
e `ice`'°?'
7
36'
3yf
DUi
//r // /*cc des a
taf+ / /1-7-` PSS/ / f/6 2--
510 N. MULLAN RD. • SPOKANE, WA99206 • (509) 927-0655
TOLL FREE - 1-800-735-6347 FAX (509) 927-4062
www snnkanoctri
RUG 30 2003 15:10
509 927 4062 PRGE.03