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2004, 04-08 Permit App: BLD-04-04028 Tear Off, Reroof Rpr 08 04 08: 58a P• 2 -- TO 5320893 P.02iO4 OCT 19 2003 12:37 FR ( • Sizikane,\114.6 1,-0 .1-1C- eY PERMIT APPLICATION WORK SHEET SPOKANE VALEY C G D�LOPMENT BUILDIN 11707 East Sprague Ave Ste 06 Spokane Valley, wA 9920 6 Phone• 6096880036 Fax:f5O1,)688-005? _REQUIRED SITE INFORMATION �_. STREET ADDRESS: lb __ ASSESSOR'STAX PARCEL NUMBER(S): LEGAL INSCRIPTION: . PERMIT DESCRIPTION: \C -(jc+c- • DDUILDING PERMIT CI CBANGE IN MSE • D GPADA:IN MANUFACTURED)10141E°RELOCATION 0SIGN OWNER /APPLICANT INFORMATION __ .______r_______A Q OWNER: `e}c. c. �- . '.( -k--& C cite 0 APPLICANT: PHONE: FAX: PHONE: FAX: t� ADDRESS: \2C)' S . C.CrC ...Vk!�`Mr.STT�. ADDRESS:• CITY,STATE.ZIP .CA ,ZIP °CONTRACTOR: \.•-C*RCVOC' i� 4 • ARCHITECT: . `J' PHONE: C`1C(-'532- SIS& 5'2 O222.—0 PHONE: FAX: ADDRESS:_\?C'1\ F Vc' C ;%<-:,(.._. C\“1C ADDRESS: CI Y.STATE,ZIP CITY.IjY,STATE,ZIP . WA ST CONTRACTOR UCENSE II 1 Ck<4”, "Ci -Chi() CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: cds q'1 S ..°° 30%SLOPES ON PROPERTY: MAIN FLOOR SO.FT:- --— BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT: - BUILDING DIMENSIONS: CONSTRUCTION TYPE: _ UNFlNHASEMENT;__ _____ NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:_ NUMBER of BEDROOMS: CRITICAL AREAS: • _ GARAGE: • DATE: _ STAFF: • MET,1O5OFPAYiMENT:• a CI o --- 0 41 CASH CHECK BANKCARDS EXPIRES; VINO ANTHOR/ZEDB/CENATuRE"^) \ APR 08 2004 10:01 PAGE.02