2012, 11-07 Permit App: BLD-2012-2026 ResidenceSpokane
.0 Valley
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 @sookaneval lev.orq
Pict # 81C1-/Z- 262
RFP"-"i'ID
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION ❑ ADDITION /REMODEL ❑ ACCESSORY BUILDING
DECK L] OTHER
SITE ADDRESS: - /L'2 iii A' 'j� 'Kv pp �� ,77��
LEGAL DESCRIPTION: L 'L. I�Li4 IZL,1.1- 460 Ai r.4 r
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
NAME: Lk L ) +L) f 1 In LJ A5 ' /,I / ((.-
ADDRESS: /L /v , ✓+ A � ✓ �,v� I ( f
CITY: ZVANIE L%L
PHONE: J 929 17 i/ FAX:
CONTACT NAME: /41.) l? EtJ) J I (IL -
55' q' %r%'7 Fax: 92-2 -Lij9S
PHONE:
L3L)
STATE: L 1 t'/
9l ,- o lG
ZIP: 9g7dd .
CELL: _6-9-4 -797g
CELL:
5-9C-7478
CONTRACTOR NAME:
ML I4- Llito33 U_C
MAILING ADDRESS: 2/z Id , as f
CITY: S End iLA- ,JE Y A'L.LL_ 7 STATE: h./04—
/fir/ // / 6195- ZIP: ` /� % Z16
PHONE: rJ [/ % 12 / / 21 FAX: .922 �J -� CELL: 7 g ?�
CONTRACTOR LICENSE No.: /jJL 401J L 2_�s1 L..EXPIRES: / '/Q 21 / 'CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCORE OF WORK IN DETAIL AND INDICATE USE & PROPSED USE:
IV l lu li LAS l L� L�J rt r4-e— G D .n.1. r✓2i4 r2 t) d✓ O
* ** *YOU MUST COMPLETE THE FOLLOWING * * **
RK N/A IF NOT APPLICABLE
Height to Peak: ,,,
L a
Dimensic�- / 7
�i/ x ��
No. of Stories: i"
Total Habitagj,?S �y c]
Space: // // [s
Main Floo FFjj
/610
Upper Flooj S FTj
4a �11
Unfinished Basement SQ
FT: —
Finished Basement SQ
FT:
Garage S9 FT: j,
<' 9/ /Id
Deck /Covered atio SQ
FT: /Lij 0
Impervious Surface
Area:
30% Slopes on
Property:
//`���
No. of Bedrooms:
?
Construction TypeWJllD
Heat Source: fie-: ,„.6 Septic:
TOTAL COST OF PROJECT: $
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 required to be su ed and subsequently approved before this application can be processed.
Effec
P.
e October 28, 2007
Page l of 2
Community Developmen 02 Administration \03 Forms - Official Versions \Permit Cerfter \Residential Construction Permit
App 10.28.07.doc
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RECEiVED
NOV 07 2012
PERMIT CENTER
PLAIINING DEPT. APPROVED
BY la, wirL,
DATE:
o102 4. h.v11,47r,1
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