2004, 03-08 Permit App: BLD-04-03704 Pole Bldg 03/30/04 09:23 $509 927 4062 SPO.STRUCTURES __ IJ001/002
OCT 12 2003 13:30 FR TO 9274062 P.01/01.00.Valley..
*lane
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206•
•
Phone: 509 -8B*O036Fax:(609 688-0037
_- _-- • 'REQUIRED SITE INFORMATION
STREET ADDRESS' CO / 2 E . 1V-1-7 S ,ble_4 e - 2/2,
ASSESSOR'S TAX PARCEL NUMBER(S)- 5 2 C74(71, 050 S
LEGAL DISCRIM1ON..
•
• PERM rDESERIP ION•. . 4 - n-t '.8i • . '
• . ' ' ... Dicanubrrr- -riticariGE•rgzsz .1)44Lizinie .. AMMANCIT—gAC/I:RED•1101te eeA
Q'SIGN. anoTam. ClE - . .
OWNER /APPLICANT INFORMATION •
it OWNER' •` APPLICANT:
RHONE; , 0 2 G -</71-ism •
/ PHONE: 9,21-O(oy,l- EAx: 927~g64,2-
ADDRSSS: • Z q G E. 91�`^ 5/t a /1
/ E
64442-44
CI7'Y,STA'I•E.ZIP . • CITY,STA ,ZIP
erCOWRACTOR__r 44'4e .�772L1 1 � ARCHITECL;
PHONE_942 7 '6/p.).1 FAX.eegrr 27-'906,2- PHONE: FAL
ADORES; ADDRESS:
CTT,,STATE ZIP CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE 41 CONTACT:. • '
•
_ PERMIT/BUILDING INFORMATION • •
COST OF PROJECT; ' 10%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:
BUILDING HEIGHT TO PEAK.J '( 1?'OCCUPANCY GROUP •
-
Via FLOOR SQ FT: •
BUILDING DIMENSIONS A�>a,.'CONS RUCTION T VF'' 'l �'"'�'`UNFIN BASEMENT: •
'HUMBER OF STORIES: STRUCTURES ON PROPERTY: ' _, FINISHED BASEMENT:,
NUMBER of BEDROOMS; CRITICAL AREAS: • ' - • . • •'
GARAGE:
FLANKING SETBACK: 'CURREW RAOPERTY SIZE: - •.
COVERED DECK
• FRONT SETBACK; CURREN*PROPERTY USE' ` 7-
DECK:
REAR SETBACK& CURRENT SEPTIC USE: • • •
LEFT SETBACK: CURRENT WELL.USE: . •.
-
RIGHT ABACK., IMPERVIOUS SURFACE AMC .
MAR 30 2004 09:23 509 927 4062 PAGE.01
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