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2003, 08-28 Permit App: BLD-03-02347 Tear Off, Reroof 400#Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT 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: 1905 6., 7 -7417, ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: PERMIT DESCRIPTION-: l�l�;'N ea)fi,o,p c Re,t'Y)] j �, 14_,K y'�I� 0RUILDING PERMIT 0 CHANGE IN USE 0.GRADING 0 MANUFACTURED HOME ®RELOCATION SIGN ®TENANT ®-E?DIER OWNER / APPLICANT INFORMATION • 1 ® �-��.K.�' OWNER: E 41) v �R-C ® APPLICANT: PHONE: '727-'5990 FAX: PHONE: FAX: ADDRESS: /1/ 9105 & 4 'c2 Q2-() ADDRESS: CITY,STATE, ZIP CITY,STATE,ZIP ® ® CONTRACTOR: ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,.STATE,ZIP CITY,STATE,ZIP . WA ST CONTRACTOR LICENSE# CONTACT: PERMIT/BUILDING INFORMATION f COST OF PROJECT:900 /002),00 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: DATE: STAFF: _ l METHOD OFPAYMENT' ® ;3' • CASH CHECK =='" twalmons BANKCARD#• EXPIRES: VIN# AUTHORIZED SIGNATURE. *e*Ue I tirnn.,- avar."%a-woo-misc.stat. • Asti \/wr \�NTasa ,Aw w�► /A�wf1