2005, 07-20 Permit App: 05002376 ReroofMAR 25 2004 i0:24 FR
Ciiial
ley
TO 5341847 P.0444 i
13UILI3ING PERMIT AtPLICAtION
City of Spokane Valley Community bevelopraent bgpitirfianf
80d/fig b/v/!lon
11707 E. Sprague Avenue, Suite 106
Spokeine Valley, WA 95206
I l ,) Phone: (609) 618-006 rex: (50) 181-007
7
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REQUIRED SITE INFORMATION
Street Address: 777'o 3
Assessor's Tax Parcel Number(s):
Legal Description: `7
PERMIT bESCRIPTION:
3 Building Pettnit ❑ Change in Use Grading [ M>attttt lctur
Relocation ❑ Tenant Improvement B Fire Safety [ athl r
OWNER/APPLICANT INFORMATION
❑ Ownor,
Phone; _ • Fax:
Address:
City State Zip Code
❑ Applicant: �o�v
Phone:
Address:
ax:
City State z1p Code
id Contractor. specialty Home Products ❑ Architect: _
Phone: 534-8372 Fax 53lC1847 - Phone: Fax:_
Address: 2222 E Mallon
Spokane, WA 99202 ...
Cftyf Stabs
Zip Code
WA State Contractor License #:' SPECIHPO11Ks
Address:
qty State 21p Ciade
Contact MARK
PERMIT/BUILDING INFORMATION
ANT TO PEAK
DIMENSIONS:
flu FLOOR SQ. FTG:
* OF STORIES:
UNRPBASEMENT SQ. FTG:
MAtN FLOOR 'TO SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGEQ. FTG:
t ECK/COV. PATIO SQ. FTG: , .,
ITEAT soUAce
OCCUPANCY 05UP:
CONSTRUCTION TYPE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA: •
COST OF PROJECT: 67/ -
�p tr S C>O. 02
30% SLOPES ON PROPERTY:
SEWER OR ONSITE SE TIC .
SYSTEM?
Method of Payment: (Faxed permit applications Will only be accepted with major benkcerd)
[v'�VtsA ❑ tthat
❑ Cash ❑ Ch
0 Mastercard
Bankcard � _ _ plres: (- - - w VINS:
Authorized Signature:
Ti 11 1 4 217105 09:37
This document originally contained
confidential edit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
PAGE.01