2013, 06-21 Permit App: BLD-2013-1179 ResidenceSpokane
4.00" Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8 -3
Spokane Valley, WA 99206
Tel: (509) 688 -0036
Fax: (509) 688 -0037
permitcenter @spokanevalley.orq
3-'11 7
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION ❑ ADDITION /REMODEL ❑ ACCESSORY BUILDING
❑ DECK ❑ OTHER
SITE ADDRESS: 522 4 , j t 1411 left-LD A L 5Pp 4—
af2EAi`-r- ASSESSORS PARCEL No.:/ .43w. (.)6,09 LEGAL DESCRIPTION: Li %, gl, i(Qnf - *QAI 12g- 17T-
BUILDING OWNER NAME:
NAME:
LU L 14-6 Mks LL LL
ADDRESS: 2(0 4. UN t Vern, / j !
CITY: 31°4601)E Y n LLL'7
PHONE: ` 9429 -) Z 1(
STATE: WI)--
FAX: A-09-922 -,0/9
CONTACT NAME: r '
ZIp: 1t2fab
PHONE: 9 9 --/2j//
CONTRACTOR NAME:
FAX: ,i%1- ZCJ /1��
CELL:
9 -79z
MAILING ADDRESS: ( /21D Ai L /V I i. /LJ / / ! / ,_57E.3%,
CITY: r((L_7��LH7JE- -- (Viola / �STTATTE�:: k,44--
PHONE: _565 / 2- / % / FAX: ✓U7 72i° .6r //J/
CONTRACTOR LICENSE NO. /J40ALe£3IL 8 EXPIRES: 14 9' /`+'
Zyy Ip: 9N0-2e,6
CELL: 19-599' 7978
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
* ** *YOU MUST COMPLETE THE FOLLOWING * * **
MARK N/A IF NOT APPLICABLE
Height to Peak: r / / //
�" LJ
Dimensions —9 7& S -y ,
Jy L
No. of Stories: /
Total Habitabl 5v
Space: /
Main Floor T:
/SC.'�
Upper Floor SQ FT:
__ __
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage S FT:
!U
Deck /Covered Patio SQ
FT: /00
Impervious Surface
Area:
30% Slopes on
Property:
No. of B���'e drooms:
Construction Type:WcvP
Heat Source: /;'
Sewer orpeptic:
TOTAL COST OF PROJECT: $
�1
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. eferenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a per it •r approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may b equired to b: su fitted and subsequently approved before this application can be processed.
Effectiv: •c :.er 28,
Page 1 of 2
P: \Community Developmen \02 Administration \03 Forms - Official Versions \Permit Center \Residential Construction Permit
App 10.28.07.doc
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PLANNING DEPT. APPROVED
BY: / A %II
DATE: &'/2/ /;Dr3
Projector, l71
RECEIVED
JUN 2 1 2013
1,S\ PERMIT CENTER
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