2013, 07-22 Permit App: BLD-2013-1452 Residence6iNJ - Zel3 —1 X52 -
Spokane
.000Valley'
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B -3
Spokane Valley, WA 99206
Tel: (509) 688 -0036
Fax: (509) 688 -0037
permitcenter@sookaneva Ilev.ora
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
NEW CONSTRUCTION ADDITION /REMODEL ACCESSORY BUILDING
DECK
OTHER
SITE ADDRESS: . , 1 15) ir7 . o %t U S yA L- F '
ASSESSORS PARCEL NO.: 5s-0-73, 24 i11 LEGAL DESCRIPTION:
BUILDING OWNER NAME:
LtT11 /SLI.3
NAME:
ADDRESS:
SN4S 13u S, Lt
Po i39 1�4i11L.
CITY: S pov.,
PHONE:
STATE: i"..3 A
FAX: CELL:
ZIP: qg 21 `I
Ali I- 10`Z.W
CONTACT NAME: L M
PHONE: qq1- (a 2-1 0 FAX:
CONTRACTOR NAME: 5 ( . 3
CELL: • Cl q I —6 2.q
MAILING ADDRESS: 7U T3U'ft kg-n-14
CITY:
?C) ��}} U`-
PHONE: -t cj I - L' �- `'10.
STATE: 1./1
FAX:
CELL: R91 —10-2-90
CONTRACTOR LICENSE No.: SKS 6u C3=i'7 BP EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
11414 sc. SFiZ w/ -rt 4o 0.4712.
* ** *YOU MUST COMPLETE THE FOLLOWING * * **
N/A IF NOT APPLICABLE
Height to Peak:
1 B 1v'/Z`
Dimensions:
40XS2
No. of Stori s:
%
Total Habitable
Space: /3-
Main Floor SO FT:
1
Upper FI orSQ FT:
/
Unfinished Basement SQ
FT: ")/A-
Finished Basement SQ
FT: /1/4)/A
Garage SQ FT:
5-011
Deck /Covered Patio SQ
FT: /oz. , ZS
Impervious Surface
Area: to ���ZS
30% Slopes on
Property: /1/41/sai,
No. of Bedrooms: "'-
Construction Type: 4-rit.i.
Heat Source: G,ag FA
ewer or Septic:
TOTAL COST OF PROJECT: $ / 41.0), )OO
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit Is for construction or on a dwelling, the dwelling is /will
be served by potable water. 2) Ownership of this City of Spokane Valley permit Inure to the property owner. 3) The signatory Is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required be subm ed a subsequently approved before this application can be processed.
Signature
Date: 7 /7 2), 3-
Updated 1 -11 -11 Page 1 of 1
http: / /www.spoka neval ley.org /fi lestorage/ 124 / 938 / 210 / 948 / 1496 / Building_ Perm it_- _Residential_11- 11- 11.doc
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