2004, 03-29 Permit App: BLD-04-03927 ReroofSpokane
jVaney
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit
n Relocation
Change in Use [ 1 Grading Manufactured Home
❑ Tenant Improvement [l Fire Safety n Other
OWNER/APPLICANT INFORMATION
Owner:
Phone:]/ -7J S/ Fax:
Address: /'///l
virCity State Zip Code
Contractor: rt -r -u-
Phone: r j 713 i/ Fax:
Address: yL///6
`7`17,7-1/6'
City State Zip Code
WA State Contractor License #:
n Applicant: �zr
Phone:
Address:
Fax:
City
Fl Architect:
Phone: Fax:
State Zip Code
Address:
City
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST F PROJECT:
30% SLOPES ON PROPERTY:
SEWER ORO -SITE TIC,)44/Co SYSTEM?
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
Bankcard #:
Authorized Signature:
❑ Check
❑ Mastercard
❑ VISA
Expires:
VIN#:
❑ Other