2004, 09-29 Permit App: BLD-04-07798 Demo ResidenceSep 24 2004 4:3SPM Rob's Demolition
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Volley, W4 99206
Phone; (609)688-0036 Fax.' (509)666-0037
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REQUIRED SITE INFORMATION i ICti4
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apt -1- 19 11/43, aqaziu¢R,.ie - di 8 17 #(44yr.aJ - rla.wvz
STREET ADDRESS: 142 21,--2& µ +1Pa'4� - CT, rnl sJ+' 512t t+ •+ ttUI�
1103 -CIS AA. M�etetute v /
LEGAL DISCRIPTION: (0,41(41
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OWNER / APPLICANT INFORMATION
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OWNER'
PHONE:
ADDRESS:
CITY,STATE, ZIPr
Cr ee (i c Giro I O.
FAX:
CONTRACTOR: see
PHONE:
AGGRESS:
APPUCA�NT: wbs DePv+1a� t li
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PHONE: —1C(2,— 11 19 FAX: 5 71 _ 4 Qy
ADDRESS'
CITY, STATE, ZIP
® ARCHITECT.'
FAX: PHONE: FAX
ADDRESS:
CITY„STATE, ZIIP/ CITY, STATE, ZIP
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WAST CONTRACTOR LICENSE / KO{� `11-0 E P D 4 se. CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 3096 SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP:•
BUILDING DIMENSIONS: CONSTRUCTION TYPE.
NUMBER OF STORIES: STRUCTURES ON PROPERTY:
CRITICAL AREAS:
NUMBER of BEDROOMS:
MAIN FLOOR SQ FT:
2140 FLOOR SQ FT:
UNFIN BASEMENT.
FINISHED BASEMENT:
GARAGE:
METHOD OFPAMEM,
Q 0
CAS/ CHECK
BANKCARD 0
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SEP 24 2004 16:44
509 534 9404 PAGE.01
Sep 24 2004 4:39PM
Rob's Demolition
509-534-9404
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SPOKANE COUNTY .UR POLLUTiON (22N11UJ1. AU 1l1UW 11
1101 West entitle., Swim 403. Spokmlc WA WN:
NOTICE OF INTENT
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A. Ptgject Type 1. a Aabntos Rwmnva1
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Mailing Maim: 905 W. Ri mStdc. Stale 405
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SOME WA Zip: 99231
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2. a All MC Demolitions With No Asbestos Rcmasytl Proms ,— --. 3 D a , . •—• S 0 --
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yam tri is comma occupied (puerto gaga Mir movatioonletiuditionl M ono Ibody who bung the property is that &add & On.! of Me
cait((eti o in 0.24 most brume Wail Wit tan"attmhftaaotitaan pr4'uM Fir .a.ta tnfan.ubat, intSCAPi:A at (509)4774727.
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NCI MID 01-03-01 11:14M PIO)h0011113u3 TO-SCAPCA PM 01
SEP 24 2004 16:45
509 534 9404
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A011 0:04
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