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2003, 09-22 Permit App: BLD-03-02544 Tear Off, Reroof
SEP 09 2003 14 57 FP Slane. TO 4677802 P.02/03 PERMIT APPLICATION WQRK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)688-0036 Fa (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: ASSESSOR'S TAX PARCELM/ LEGAL INSCRIPTION: PERMIT DESCRIPTION: t/BUILDING PERMIT ®CHANGE IN USE 131 GRADING ✓®RELOCATION QS1GN °TENANT ® MANUFACTURED HOME: DOTTIER OWNS `PHONE: ADDRESS: 07- a/2_ /' OWNER / APPLICANT INFORMATION FAX: • 41 1. 'y zt ,000NTRACTOR:C�� "p �7 "PHONE `0aq 7 -v -9/i .. ADDRESS: ii.90 Y 7' 77'^' "' tia-lztLW': ADDRESS: /�j ~C „STATE, 21P9 0q/7- 7f WA ST CONTRACTOR LICENSE d OREMLa ym - CONTACT: ® APPLICANT:_ PHONE: pORESS: ARCHITECT: 601){/'61-'79 Z PHONE: • PERMIT/BUILDING INFORMATION COST OF PRCJECT'�/O�� 30%SLOPES ON PROPERTY: BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: BUILDING DIMENSIONS: CONSTRUCTION TYPE: NUMBER OF_STORIES: STRUCTURES ON PROPERTY: NUMBER of BEDROOMS: CRITICAL AREAS: I DATE: MAIN FLOOR SO FT: 2ND FLOOR SC FT: UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: ncmv✓vim_-•-_,_• ___.. _ __ _. _.. ___ _ CASH' CHECK Q E” 0 ttA%YKCARD EXPIRES:VINO` AUTNORWWED SIGNATURE: r i+i& ' 45