2001, 05-08 Permit App: 01003350 Reroof5
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PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OP BUILDING K CODE ENFORCEMENT
1026 WEST BROADWAI' AVENUE
SPOKANE, WA 99260
509977-3675
SPECIFIC SITE INFORMATION
Street Address:
E. 12122 Valleyway
Assessor's Tax Parcel Numbee(s):
Legal Description:
ProjedDescription: Tear off and reroof.
Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
OWNER/APPLICANT INFORMATION
CI Inarcar andn snoora Olt contacts regenturt ten pro rrt
O owner: Pt,ona: 535-9992
Stan Green Fat
0 Applicant:
Dime
Fa:
Medine Addmr
Mul:nr Addrrra
Cop Asea, Zip
wSEI.
Ger, Stat Zip
W Cantona Pbore —
Spokane Roofing Co. n.13:747-8990
0 Aabhtct/Eerinnr
Mont
F e
M.Wng address
E. 130 Sprague
wigns eldrev
City. Asn tip
Spokane, WA 99220
Cary. Sawn Zip
WA Scar Comnncr Ilene r
SPOKAR*340L7
Canna Ma
Hem source (electric, gas, no
05/04/2001 FRI 09:51 FAX 509 477 7592 SPOKANE CO BLDG -CODE ENF
sr .
1002/002
What is the sapeare Innate of the sign
feed
How high is the sign?
Area of raining rigor
Are there scructuresaa the property? 0 Yes O No
!f ya, identify on sire Nen
What is the current property size?
(square feet nr arres)
Is any part of the property within 250 feet of a shoreline?
If yes, :denrify on the plea 0 Yes 0 No
What is the current use of this property?
'
h yotr property in a designated wildlife hebitar arra?
O Don't know O Yes 0 No
Will rbe site be served by 2 septic spiral? O Yes 0 No
Is soy part al the property warhiu a 100 yr flood grin?
Ifyet. identify on site pine
O Maybe 0 Dunt know 0 Yes 0 No
Are or will there be wells located on the property?
lbw. identify on thr site plan 0 Yrs O No
Are there any wetlands, stscaots os ponds wit kin 200 (vet of the
Property?
(yes,idenrrfy on site plan O Yes 0 No
Is there evideoce of fill nr rxcavatiou on the property?
D Yes O No
.
Are there slopes greater than 3096 on tie property? (30 fr rise in 100 h)
(_,.-----"96) O Yes O No
Are eritirn7 or hazardous materials used or stored on site?
O Yes 0 No
DEPARTMENT USE ONLY
Date Removed:
4E 1'HOD OP PAYMENT
CASH D CHECK 0 ® ❑ i
FAKED PERMI'T'S WILL ONLY BE ACFPTED WITH PAYMENT OF A MAJOR CREDIT CARL)
>ATE:
IANKCARD NUMBER.
pUTHORIZFD SIGNATURE.
EXPOSES.