2003, 10-15 Permit App: BLD-03-02784 Reroofe
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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
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STREET ADDRESS:
ASSESSOR'S TAX PARCEL-NUMBER(S):
LEGAL DISCRIPTION: �/� o
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PERMIT DESCRIPTION:
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OWNER / APPLICANT INFORMATION
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® APPLICANT:
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WA ST CONTRACTOR LICENSE
FAX:
CI TATE, ZIP
ARCHITECT:
PHONE:
ADDRESS:
CITY, STATE, ZIP
FAX:
CITY, STATE, ZIP
# 3 CONTACT:
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PERMIT/BUILDING INFORMATION
COST OF PROJECT: 3000
30% SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP:
BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT:
NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
MAIN FLOOR SQ FT:
2N0 FLOOR SQ FT:
DATE: (le
STAFF
METHOD OF PAYMENT:
CASH
CHECK
VISA
MONIONINIE
BANKCARD /f; EXPIRES:: VIN #
AUTHORIZED SIGNATURE•
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