2012, 09-12 Permit App: BLD-2012-1569 Residence0
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 Pspokanevalley.orq
(Staff Use Only)
PERMIT NUMBER: 1$ (CI -(2-
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION
DECK
SITE ADDRESS: %I'Z(,9 �:
ASSESSORS PARCEL NO.:
IN ADDITION /REMODEL
.OTHER
N
06 o
ACCESSORY BUILDING
LEGAL DESCRIPTION:
!, 4111. ,
BUILDING OWNER NAME: L. I9
NAME:
EI 141)P4
ADDRESS: Vf' Nit 9 Nt[\ 4"
CITY: /"190KINrtt, U I'
PHONE: 1'
CONTACT NAME: CAW U ,
STATE:
FAX: 171` 0-/r71
ZIP: '9�
CELL: !j -0
PHONE: ' � & 1( t) FAX: - CACI CELL: 2j17-•64a.,2
CONTRACTOR NAME: 14vt -f L L
MAILING ADDRESS: 1(2 Ni 1 I ,lr f�G4'f ' v
Yj
Cm: t7 4 4 rA 14i' T
STATE: klb,
ZIIP:Cl r/ (L,
l!/
PHONE: (/ I ?� FAX C - o{ 7 CELL: 11" (4 /3d
CONTRACTOR LICENSE No.: I f4L4 J.M{vmia, EXPIRES: 7.19%101 Cm BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
* ** *YOU MUST COMPLETE THE FOLLOWING * * **
ABLE
Height to Peak:
Dimensiors:li .. it
[r) JL (G7l''ilJ
No. of Stories: .
(
Total Habitable �1 •�
Space: �' ✓(�2
Main Floor S
iTa
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT: —�'-'
Garage SQ FT: 4/
G,44'
Deck /Covered Pa o SQ
FT: 70
Impervious Surface
Area:
30% Slopes on
Property: T__>
No. of Bedrooms: _
Construction Type: O)t7
Heat Source: 44,4,
Sewer r Septic:
TOTAL COST OF PROJECT: $
75, 000
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 b quired t... submitted and subsequently approved before this application can be processed.
Eff . ve October 28, 20 ' 7 Page 1 of 2
P: \Community Development \02 Administration \03 Forms - Official Versions \Permit Center \Residential Construction Permit
App 10.28.07.doc
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