2003, 09-05 Permit App: BLD-03-02395 Finish Basement • r1 �
sonokan 63E s
4.000 Valley 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: ► U '
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION-: , \t\'‘S\A \00.6 Irvu2-vy\-
1►R BUILDING PERMIT a CHANGE IN USE a GRADING a MANUFACTURED.HOME
QRELOCATION ®•SIGN- Q TENANT ()OTHER
OWNER / APPLICANT INFORMATION r
® OWNER: l 1 )0a Q 0 1 U C! PAA Ito D APPLICANT:
PHONE: CO H-, l-S� FAX:: PHONE: FAX:
ADDRESS: I 7 0 J�, r� �� - ADDRESS:
CITY,STATE,ZIP CITY,STATE,ZIP
®CONTRACTOR: 1( ® ARCHITECT:
PHONE: FAX: PHONE: FAX:
ADDRESS: ADDRESS:
CITY,.STATE,ZIP CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE# CONTACT:
IPERMIT/BUILDING INFORMATION
COST OF PROJECT: C .1 51j0 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT:
BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT:
NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
__
--6/71"177----1, STAFF: __. ..... .. —
METHOD 6-F7-PAYMENT:
a a a
a 1111111111111111111
CASH CHECK 1 VISA
BANKCARD#; EXPIRES: VIN#
AUTHORIZED SIGNATURE:
*raven n, n... . a an••a a .an.a•.III ■ A..../flrS I.OTI/..S tar.fb..Itea A fr.