2004, 10-04 Permit App: BLD-04-07837 Tear Off, Reroof FROM : ALPINE CONSTRUCTION FAX NO. : 5094485504 Oct. 04 2004 10:27AM P1
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4.00Valley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206. .
Phone: 609 688-0036 Fay 509)688-0037
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REQUIRED SITE INFORMATION
• A
STREET ADDRESS- [ 3 Do S E a
ASSESSOR'S TAX PARCEL NUMBER(S)
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: 7' 'A.. o ice -- 12e,v00I`
OBVUD1NG•PERMIT .aCHlANGE IN USE • 0 GRAD . .FMANRACTURED HOME
RELOCATION I SIGN EI TEN
• 4.8 OWNER ! APPLICANT INFORMATION
vrGK 11- ® APPLICANT: C)'" e-,,i s �PN�
Q OWNER: NL,A-LLK- /44- �
PHONE:
FAX: PHONE: FAX:
ADDRESS: ADDRESS: CITY,STATE,ZIP
CITY,STATE,ZIP
V�ICONTRACTOR:tI�' --P"4 a CO.0 Sr ft,v c.:.. .1'4 ARCHITECT:
9 9 r -41‘"1r -41‘"1 PHONE: FAX:
PHONE:4�g" $0 FAX: LIV•�'
ADDRESSM Ig E 4"4"1144ic a WI- qq 2-1'3 ADDRESS: CITY,STATE,ZIP
CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE*!A''a►N a 2K O$`'i""'4/ CONTACT: � .
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Laiwaisiia PERMIT/BUILDING INFORMATION
COST OF PROJECT: v- 1
S 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:
FLANKING SETBACK:
CURRENT PROPERTY SIZE:— COVERED DECK:
FRONT SETBACK:
CURRENT PROPERTY USE: DECK:
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE: __ ('1 3 -
RIGHT SETBACK: IMPERVIOUS SURFACE AREAL____—. I aG� _l
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