2012, 11-09 Permit App: BLD-2012-2045 Residence"71(NEW CONSTRUCTION II ADDITION /REMODEL
DECK OTHER
SITE ADDRESS: ? I' t\IL. Lt?
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: 2LKS —E - > ft.
BUILDING OWNER NAME: J, f4{ ,.}iovt 1,1,1
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B -3
Spokane Valley, WA 99206
Tel: (509) 688 -0036
Fax: (509) 688 -0037
permitcenterOsooka nevalley. orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
ACCESSORY BUILDING
NAME: V ,� ft Ot tig& LL
ADDRESS: -1CD " .+� U[ fi 1f !Sr -V(/
CITY:
STATE: _ ► ZIP:
PHONE: .5e/7 - 7 9 Z G 6 ' / ? Fax: Cn 9
CONTACT NAME: I/�7L r
t FAX: l %a - a_ 1 J CELL 9- 717S
9
CONTRACTOR NAME: L qk ILL
PHONE:
CELL: . -797Z
MAILING ADDRESS: Z I 0 14-, LI V rile trr * 1 *.f f
CITY: 4 / r e33ij V� STATE: k ZIP: �� !► �/�►
-� C f
PHONE: � Y FAX: � � 0 � 6
CONTRACTOR LICENSE NO.: L.441440 Ij, ItJ EXPIRES:'_ 1 '2ti(4 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WQ,RK I N DETAIL AND INDICATE USE & PROPOSED USE:
W , g.k4 lD ogergm. Lot-t<Micerl ez0
Hei ��o -al1i
Mair lgr,Sii :
Garage SQ FT•
410 I'
No. Bedrooms:
****YOU _MUST COMPLETE THE FOLLOWING****
MARK N/A IF TROT APPLICABLE
s_ No. of Stories:
Dim
si
Upper Floor SQ
Unfinished Basement SQ
FT: ----=
Total Habi�
S ce:
Finished Basem - t SQ
FT:
Deck /Covered do SQ
FT: [BSS. .,
Construction
Impervious Surface
Area:
Hea
30% Slopes on
Property: - —
TOTAL COST OF PROJECT: $
Se
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) If thls permit is for con as�rnnn �� rn� is/ 111
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner The signatory is the propelty
owner or has permission to represent the property owner in this transaction. 4) All construction is to be donejrf fuit complance 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 oradditional
information may be required to be submtyted and subsequently approved before this application can be �.9 201.
R tai] (T C F N T_F R
Effect‘ October 28, 2007 %
P: \Community Development\02 Administration \03 Forms - Official Versi
App 10.28.07.doc
Page 1 of 2
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