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2004, 09-10 Permit App: BLD-04-07620 Tear Off, Reroof FROM : ALPINE CONSTRUCTION FAX NO. : 5094485504 Sep. 02 2004 04:46PM 'P1 e ccl a 1-' - rib -C ,,,Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIV/S/ON 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206. . Phone: 509 688-0036 Fax: 509 688-0037 7 REQUIRED SITE INFORMATION STREET ADDRESS: 1/ 302 6s- /2, - ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL INSCRIPTION: • PERMIT DESCRIPTION: TC71-A• OAF0`'f ,Efi3V .])DTG•PEI T • CUCHANGE IN USE aGRADING .CIMANUFACTURED HOME CIRELQCATION . aSIGN . OTENANT a MEER1 . Ifiaziamossiase2 •• OWNER / APPLICANT INFORMATION CI OWNER: • ® APPLICANT: FAX: PHONE: FAX PHONE: • ADDRESS- ADDRESS:CITY,STATE,ZIP • CITY,STATE,ZIP • CONTRACTOR:A LP ii,J e" Gems S i it.J cr i J 0 0 ARCHITECT: PHONE: tie• 5°11 .FAX y-ki u S'S/34 PHONE: FAX: ADDRESS:4 9 cI -t-NNA 12 F Da SP 19 ZZ3ADDREss; CITY,STATE,ZIP CITY.STATE,ZIP ^� WA ST CONTRACTOR LICENSE*ALP',Alt-4e 0$E1 MA) CONTACT: w kt i`3 5 PERMIT/BUILDING INFORMATION LiEssiiii=r, ....06-.1 COST OF PROJECT: 7;1-1 S. ' 30%SLOPES ON PROPERTY:, MAIN FLOOR SQ FT:___._ BUILDING HEIGHT TO PEAK: QCCUPANCY GROUP: 2N0 FLOOR SQ FT:_ BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT:_____ •NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED EASEMENT:, 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: SEP 02 2004 16:43 5094485504 PAGE.01