2003, 08-30 Permit App: BLD-03-02372 Pole Bldg 09/02/03 14:04 $509 927 4062 SPO.STRUCTURES lZ1 004/005
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNI7YDEVELOPMENT
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: o(. // ‘, 4-4 5, 2 (i 4 /(e 7( /A.44 5'1 2 c,
4
ASSESSOR'S TAX PARCEL NUMBER(S): 'c2-0( . /Of O _
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: P_ ..5--74" f vtz tAl B -
13‘u11.3 NG FERN= aCHANGE IN USE 0 GRADING 0 MANUFACTURED ROME
QRELOCATION SIGN °TENANT DOTER
OWNER /APPLICANT INFORMATION
OWNER: 0:14}C LGL.€ PO i1 C: [3/APPLICANT: 5 a C Ite 2-/(C $'c'
PHONE: ?2 / /q 2'( FAX: PHONE: 7.2-1'Ef,60S-. FAX: 4127'x/0 2..
ADDRESS: l Off LI" / ADDRESS: 570 N. u.tvil.4 1,(d, sflo14-12
/I I CITY,STATE,ZIP CITY,STATE,ZIP
CONTRACTOR: ..5,14-414, 51`Z 1/<1 C .CI ARCHITECT:
PHONE: ( �7 --O(o55 FAX: c27b(.Z
PHONE: FAX
ADDRESS: 5I D Al- !/LLQ/141.. )J • L v tt ADDRESS:
CITY,STATE, IP CITY,STATE.ZIP
WA ST CONTRACTOR LICENSER CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
/
BUILDING HEIGHT TO PEAK: /2 OCCUPANCY GROUP: 2ND FLOOR SQ FT:
BUILDING DIMENSIONS: M X 2!/1' B CONSTRUCTION TYPE: ?r414- rfraa cc- UNFIN BASEMENT:
NUMBER OF STORIES: I STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE:
FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: DECK:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL.USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
AUG 30 2003 15 10 509 927 4062 PAGE.04
09/02/03 14:04 $509 927 4062 SPO.STRUCTURES Z005/005
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AUG 30 2003 15:10 509 927 4062 PAGE.05