2013, 08-16 Permit App: BLD-2013-1649 Basement RemodelS b' lean
es•OValley•
•
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@spokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
(9
RESIDENTIAL CONSTRUCTION PERMI.LAPPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL
• DECK • OTHER
}E ACCESSORY BUILDING
RECEIVED
SITE ADDRESS: 12808 E Blossey Ave
ASSESSORS PARCEL NO.: 45272.1630 LEGAL DESCRIPTION:
11 Sp9le•U.n4040
BUILDING OWNER NAME: Gibson, Melissa/Robertson, Justin
pt
NAME: Justin Robertson
t..oV rtNrvii I GEN LER
ADDRESS: 12808 E Blossey Ave
Lbuts # (_'_j REV. #
Construction Type:
CITY: Spokane Valley
STATE: WA
PHONE:
FAX:
zip: 99216
CELL: 509-8634063
CONTACT NAME: Gibson, Melissa/Robertson, Justin
PHONE:
FAX:
CELL: 509-863-4063
CONTRACTOR NAME: Gibson, Melissa/Robertson, Justin
MAILING ADDRESS: 12808 E Blossey Ave
On.: Spokane Valley
STATE: WA
zip: 99216
PHONE:
FAX:
CELL; 509-863-4063
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
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****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: NA
Dimensions: 40x27
No. of Stories: 1
Total Habitable
Space:
Main Floor SQ FT:
1100
Upper Floor SQ FT:
NA
Unfinished Basement SQ
FT: IUOU
Finished Basement SQ
FT:1080
Garage SQ FT:
648
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property: NA
No. of Bedrooms: 2
Construction Type:
Heat Source: Electric Baseboard
Sewer or Septic: sewer
TOTAL COST OF PROJECT: $ 3 00 0
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 to be submitted and subsequently approved before this application can be processed.
Effective October 28, 2007 Page 1 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
• •
Signature
Date:
8/6/x03
Method of payment: ❑ Cash ❑ Check
Bankcard #:
❑ Visa ❑ Mastercard
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc