2003, 09-04 Permit App: BLD-03-02388 Roof TrussesATE:
Spokana" e
is, Valley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BU/LD/NG DIVISION
11707 East Sprague Ave Ste 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 DISCRIPTION:
PERMIT DESCRIPTIO 4: `-1(.4t 0 /'1;i-) Gly c.L4
a BUILDING PERMIT 0 CHANGE IN USE GRADIN- 0 MANUFACTURED HOME
Q TENANT 0- titER
®RELOCATION
®" SIGN
OWNER / APPLICANT INFORMATION
® OWNER: C-1'ZLz
i�(11ie 1/C—/ ® APPLICANT:
PHONE::) )/ ` 711) FAX: fj .PHONE: FAX:
ADDRESS: J 2-2 ( 7 (i) /
CITY,STATE, ZIP
® CONTRACTOR: (g -z/6
ADDRESS:
CITY, STATE, ZIP
® ARCHITECT:
PHONE: _)t1 7 J u-- FAX: PHONE: FAX:
ADDRESS: ADDRESS:
CITY,.STATE, ZIP CITY, STATE, ZIP
. WA ST CONTRACTOR LICENSE # CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: t' `-f) 30% SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT:
CONSTRUCTION TYPE: UNFIN BASEMENT:
BUILDING DIMENSIONS:
NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS:
CRITICAL AREAS:
GARAGE:
STAFF:
METHOD OF PAYMENT:
CASH
CHECK
VISA
BANKCARD #; EXPIRES: VIN #
AUTHOR/ZED SIGNATURE:
*CAVCl1000uulT w an/ 1A•"PIA Air. SA/8I 1 Anil V el... £ t&DTI• u• lan A A AM/AA