2012, 06-14 Permit App: BLD-2012-0871 Additionrl
ommunity Development Department
1703 East Center
Sprague Avenue, Suite B-3
�'/cln'of71 Spokane Valley, WA 99206
rmi/`J� 1Y79GAd Tel: (509) 688-0036
Fax: (509) 688-0037
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(Staff Use Only)
HERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION tJ ADDITION/REMODEL
ACCESSORY BUILDING
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SITE ADDRESS: 19 IS S BtAtr 26
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Project # Sid (2 2,7 (
ASSESSORS PARCEL NO.: G/s-Z7 y, is 7/
LEGAL DESCRIPTION:
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BUILDING OWNER NAME:
Finished Bafiement SQ
FT: N/A
NAME: ill mica LISA Pawn!_
Deck/Covere Patio SQ
FT: 0
JUN 1 4 LUIL
ADDRESS:: /yJS QL
S AKE 2D
No. of Bedrooms: /
CSV PERMIT CENTER
CITY: SPQkt4,)r V4 -tit -1
STATE: I.v4?
SUB # ZIP: j/ /IK!'LW #
(SOQ)- - — -
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: 4 y -
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CONTACT NAME: ,) ASo4 C Av tt rJ
CELL: Q39'R929
PHONE: (s cj) 99/-679g
FAX:
CONTRACTOR NAME: W C)4v2Ca
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Cori ST2vc7)o,i
CELL: 544,1E
MAILING ADDRESS: 2 2 2 7 A)
to&G 20
CITY: SPoiLitkie V4tu'/
STATE:
LSA
ZIP:. 9906
PHONE: (SOR) 991-671-M
FAX: /c//a CELL: SArME
CONTRACTOR LICENSE NO.: 3WCAUC02 /LCEXPIRES: S/20 13 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 NO
Height to Peak: is,.. /
Dimensions:
301931
3 i
No. of Stories: /
Total Habitable 7p,O /
Space: J /
Main Floor SQ FT9D r
Upper Floor T:
f)
Unfinished §asement SQ
FT: N/4
Finished Bafiement SQ
FT: N/A
Garage SQ FT:
,si
Deck/Covere Patio SQ
FT: 0
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms: /
Construction Type: wpob
f—
Heat Source: eC7yli(
PrwerT or Septic:
TOTAL COST OF PROJECT: $ 30 /4
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 requihed to be submltteand subsequently approved before this application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of.1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_ _Residential_11-11-11.doc
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PLANNING DEPT. APPROVED
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Project #
RECEIVED
JUN 12 2012
CSV PERMIT CENTER
SUB #(
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