2006, 05-22 Permit App: 06001928 ReroofMAY -19-200E 02:21P FROM:
}1e 11707 E Sprague Ave, Suitt ] 06
�[ elley Spokane Vasy, WA 99206
,401011.1F
V-d (509)688-0036 FAX: (509)686-0037
Community Devcloptn t www.spok2rc-va ieY.or,.corn
Residential Construction
Permit Application
TO:e9B0037
P: 1'/ 1
PERMIT NUMBER: /f
PERMIT FEE:
o New Construction
o Addition/Remodel
o Other:
SITE ADDRESS a k t a (.4 4 t7 �J t -.A
ASSESSORS PARCEL NO:
o Accessory Bldg
o Deck
LEGAL DESCRIPTION:
Building owner
Name: •,1$1zi LiObD
Address: C. Q lE5C,SC 1tr:t.13
City: 5$aK.Ar0e, Zip: CItcl i,1 4
Phone: Fax:
Contact Person . 3a E,
Nance:
Phone:
q -?t- il93
Describe the scope of work in detail: Cost of Project:
$ 3, 98q•O(Q
p
**************The following MUST be complete: (write NIA if not appiicabte)**********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
_Contractor
Nanoe:ROCR.0 60D ? p� - tt.Y.
MAIN FLOOR TO SO.
FTG:
Address: 9_0 --1 1114.
UNFIN BASEMENT SO. FTG:
City: ZQ011.H Ups Zip:
�
�
1'
Phone: �- S. 1 �J Fax:
Lie No2C0Q ,1- l ti.pExp. Date:
# OF BEDROOMS:
CONSTRUCTION TYPE:
City Business Lie No:
SEWER OR SEPTIC?
Describe the scope of work in detail: Cost of Project:
$ 3, 98q•O(Q
p
**************The following MUST be complete: (write NIA if not appiicabte)**********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SO.
FTG:
2'. FLOOR SO. FTG:
UNFIN BASEMENT SO. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SO. FTG:
GARAGE SQ. FTG:
DECKICOV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
DISCLAIMER
The perrnitee verifies. acknowledges and agrees by their signature that: 1) If thls permit is for construction of 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) AU 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) This 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.
Sig
•
Date
accepted with major bankcard)
Mastercard 0 VISA
Ex• rex: VINt3:
0 Other
Authorized Signature:
REVISED easrloos
PAGE.01
MAY 19 2006 14:44