2005, 05-20 Permit App: 05001706 Relocate Residence renewal BD-03-859PERMIT 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: / / / ,9 /QC//4 //
ASSESSOR'S TAX PARCEL NUMBER(S): ?:15-76)-23 l 12 THIS BUILDINQSUBJECT
ECTIONS
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
gBUILDING PERMIT • U CHANGE IN USE 0 GRADING
DRELOCATION
Er SIGN • 13 TENANT
OMANTIFACTURED .HOME
-OTHER... • .
OWNER / APPLICANT INFORMATION
® OWNER: 04
PHONEt S--ePT i -/em-FAX:-.50 7—
ADDRESS: 6-36:),
CITY,ST,6 E, ZIP
®CONTRACTOR: Oa7/l/L 7?
PHONE: FAX:
ADDRESS:
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE #
APPLICANT:
PHONE: FAX:
"MESS:
CITY, STATE, ZIP
CI ARCHITECT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: / % /
BUILDING DIMENSIONS:
'NUMBER OF STORIES: 1
NUMBER of BEDROOMS: �-
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
30% SLOPES ON PROPERTY: A/0
OCCUPANCY GROUP:
CONSTRUCTION TYPE: ri4/17,C
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE: t9.)C)35-
CURRENT PROPERTY USE: ii -f-5
CURRENT SEPTIC USE: S� fiQ
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT: /43-6
2N0 FLOOR SQ FT:
UNFIN BASEMENT: )/CS
FINISHED BASEMENT:
GARAGE:
COVERED DECK:
DECK: