Loading...
2004, 08-18 Permit App BLD-04-07402 Re-RoofE Architect: Phone: Fax: Address: City ❑ Mastercard Expires: ❑ VISA State Zip Code VIN#: State Spokane v�ley BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: A/ i b Si* o .l 1-k e rJ Assessor's Tax Parcel Number(s): L-1504-43.OlDa� Legal Description: No v 5 e PERMIT DESCRIPTION: /Qt. gob © Building Permit [I Relocation E Change in Use ❑ Grading fl Tenant Improvement ❑ Fire Safety ❑, Manufactured Home j1 Other OWNER/APPLICANT INFORMATION ❑ Owner: T� h n n.y rg, 9 /c h e ✓ Phone: coy.q2 q s5j 9(, Fax: Address: Ai loos perrrNe City ( State Zip Code City State Zip Code Applicant: Phone: Address: Scam 2 Fax: ❑ Contractor: Phone: Fax: Address: City WA State Contractor License #: Contact: Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK DIMENSIONS: # OF STORIES: MAIN FLOOR TO SQ. FTG: 2D1t FLOOR SO. FTG: UNPIN BASEMENT SO. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 36% SLOPES ON PROPERTY: SEWER OR ON -SITE SEPTIC SYSTEM? Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash Bankcard #: Authorized Signature: ❑ Check ❑ Other o7Lf0-