2004, 05-28 Permit App: BLD-04-04466 Garage . .0v N... F-2/o
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA.99206. ..
Phone:(509)688-0036 Fax:(509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: //oil`l J • 57a-Zi C T.
ASSESSOR'S TAX PARCEL NUMBER(S): 11,5-2-214 ?/33
LEGAL DISCRIPTION: //ay S • 57 i G7; L-3 3'Z SHE-icy / y
PERMIT DESCRIPTION: i)e7(-0.cji,p i-
®DU)„DING PERMIT 13-CHANGE IN USE 0 GRADING a I UF'ACTURED HOME
0-RELOCATION ®-SIGN 0-TENANT 0-OTHER
OWNER / APPLICANT INFORMATION
® OWNER: fNI/L Lf W/,5' ® APPLICANT:
PHONE: 579f-f2-2-^Z737 FAX: PHONE: FAX:
91103
ADDRESS: //Of $ ST-t "i CK
T.� S •VAtt girtgirt, ADDRESS:
ITY,STATE, 1P - CITY,STATE,ZIP
°CONTRACTOR: 7 WM t 6V47 vVi //tI OZ5 ARCHITECT:
PHONE:/'cir Q0/4,,,,, � FAX: �/ PHONE: FAX:
ADDRESS: 6/t. •meat' 5;24/[.V4Ud4 JyZ/Z/ ADDRESS:
CITV,.STATE,ZIP CITY,STATE,ZIP
to
WA ST CONTRACTOR LICENSE# �u/4C3i/0547 CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT: M
BUILDING HEIGHT TO PEAK: IC-I-61 OCCUPANCY GROUP: v 1 2ND FLOOR SQ FT:-
—
BUILDING DIMENSIONS: X CONSTRUCTION TYPE: f0$T F 4rii UNFIN BASEMENT:
NUMBER OF STORIES: ( STRUCTURES ON PROPERTY: / FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: / ,-CiZC COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: 5/f 'G4 DECK:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
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