2005, 04-14 Permit App: 05001195 Deck Stairway (Ciii5
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10.1"\S • BUILDING PERMIT APPLICATION WORKSHEET
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City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
.000Valley Spokane Valley, WA 99206
Phone: (509) 688-0036;Fax; (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: /7 7/ 3 *. .
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit ❑ Change in Use El Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: G+.'L &'/e-Sd 1k' ❑ Applicant: #C, 1171-le-T),
Phone: 813-2zat§ax: Phone: .1Z)..7% Fax:
Address: /77/ 3 t, el AA. Address: he --Sds.,... c ._40A2,
U.1-• 914'0./4► 1J/y 1.44- - €792-,2__Ci State Zip Code City ate Zip Code
C Contractor: /ea/7 �Af f/ ❑ Architect:
Phone ,2_7-74/4,e Fax: Phone: Fax:
Address: ids-- . e.... 'r - aat, Address:
• 1147 I4 . RrtCode2-
City State City State Zip Code
WA State Contractor License #:/ N['T- /•�Q p Contact: I ,01 r/
17-141
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 2""FLOOR SQ. FTC: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
d.L4fe._ 57r4-e.e S
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COSCO55 OFA PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
1] Cash R_Check 333
0 Mastercs ❑ VISA El Other
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Bankcard#: �7�c, Sq✓ V �p ./ Ex 0 VIN#:
Authorized Signature: /E4 '
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REVIEWED FOR CODE COMPLIANCE
'OKANE VALLEY BUILDING DIVISION
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CITY COPY