2003, 11-26 Permit App: BLD-03-03154 Additionr
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PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITYDEVELOPMENT
BUILDINGDIVISION
11707 East Sprague Ave Ste 906
Spokane Valley, WA 99206
Phone: (509)68�0036Fax.- (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:/l0 2 D E, 2 IVZ,> �t �' PO U,�J/✓� , j,{� 9 2 O 6
ASSESSOR'S TAX PARCEL NUMBER(S�:
LEGAL DISCRIPTION:___®�5�
PERMIT DESCRIPTION: ST 0 i9 45e-
p -BEING -P r - 8a -c> GE -IN. -USE - EIGRADIrG 13,A=
E}.REI,OCATION [JSIGN- EtTEN ANT E}t R 10 `��G�
OWNER / APPLICANT INFORMATION
® OWNER: z-1 G D In 0,(/ 6
PHONE:��-Z FAX: ���
ADDRESS:/
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CITYATATE, ZIP
® CONTRACTOR: - �� �✓' S T
PHONE:-fQnl
ADDRESS:_m"// �Y f� !i/Zli(f / W .
CITY,.STATE, ZIP
WA ST CONTRACTOR LICENSE # ERCO Nl ?�- 2-41 /�"8
COST OF PROJECT: q SSD O
BUILDING HEIGHT TO PEAK: % 3
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APPLICANT: G- / ; 1 ' e5'0 /V s 7 ,
PHONE:- 7 O FAX: 9Z- /ZJJ
ADDRESS:__
CITY, STATE, ZIP
ARCHITECT.:
PHONE: FAX:
ADORE
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
BUILDING DIMENSIONS: Q 7-10
-NUMBER OF STORIES: i
NUMBER of BEDROOMS:
FLANKING SETBACK: /o
FRONT SETBACK: X91 4 4 t
REAR SETBACK: ! �
LEFT SETBACK:
30% SLOPES ON PROPERTY:
` MAIN FLOOR SQ FT: /3 4 .5
OCCUPANCY GROUP:.
2ND FLOOR SQ FT:-
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CONSTRUCTION TYPE:
UNFIN BASEMENT,
STRUCTURES ON. PROPERTY: '"
FINISHED BASEMENT:
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CRITICALAREAS: /yo/y
GARAGE: � Z ev
CURRENT PROPERTY SIZE:
COVERED DECK:
CURRENT PROPERTY USE:
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CURRENT SEPTIC USE:
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
14- 2. 28
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PLANNING DEPT. APPROVED
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DATE: -1 I )x
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