2003, Permit App: BD03-794 Reroof sifolandl/e\
40011111F' lley
PERMIT APPLICATIONYV ORK 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: 1 Z-1 . e lc i H
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: ROO EL A.)Co
]BUILDING PERMIT 0 CHANGE IN USE 0 GRADING 0MANUFACTURED HOME
RELOCATION 0 SIGN 0-TENANT 0-0 FLIER
OWNER / APPLICANT INFORMATION
OWNER: CI APPLICANT:
PHONE: FAX: PHONE: FAX:
ADDRESS: ADDRESS:
CITY,STATE,ZIP - CITY,STATE,ZIP
®CONTRACTOR: 6G(-14:,v.0 CO 4JS c EE ARCHITECT:
PHONE: e[2? FAX: PHONE: FAX:
ADDRESS:E77 11-i K4 C ti 4 9I2 ADDRESS:
/ CITY,.STATE,ZIP CITY,STATE,ZIP
WA ST CONTRACTOR LICENSE# G'L A C D C3 ,IC 2 CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: ®Oo 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:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA: