2003, 10-06 Permit App BLD-03-02698 Basement Windows stizCsts.t.„
.000Valley
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: r� � N Coke h'I^GCYn Imo`. 5+„KC\I' , kAllet+ , 1,0 /l02
ASSESSOR'S TAX PARCEL NUMBER(S): 3S I O'I.. 9031 J
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: F5res,, w,r.tc,
a BUILDING PERMIT El CHANGE IN USE E GRADING 13 MANUFACTURED HOME
DRELOCATION ri SIGN Q TENANT 0 OTHER
OWNER / APPLICANT INFORMATION
pOWNER: 1.,0Gk? mC(?oc( jC le ® APPLICANT:
PHONE: (`jCn r
�4-9a7S FAX: PHONE: FAX:
ADDRESS: R-C1 ll). CcL .,-,fAlcii2c1. Sp, ,IIQ,ff Le)-A-9rl21L ADDRESS:
® ITY,STAYE,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
COST OF PROJECT: v .l)° 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:
METHOD OF PAYMENT:
0 0 0 E ® maimmi
CASH CHECK ' y. VISA
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BANKCARD A`; EXPIRES: VIN#
AUTHORIZED SIGNATURE: