2007, 05-11 Permit App: 07001721 Windows, SidingPermit Center
CITY 11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokaoevalley.org
Residential Construction
Permit Application MAY
Community Development
PERMIT NUMBER: 7—/izj
PERMIT FEE:
New Construction Accessory Bldg
Addition/Remodel fl Deck
Other:
SITE ADDRESS: 7S/j e
Z.>
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building Owner:6.,/,„
/
d
Name:
MAIN FLOOR TO SQ.
FTG:
2Nu FLOOR SQ. FTG:
Address:»2 z; -
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
CitY:43
State:A ja
Zip: cmo7
Phone: q zg gg
Fax:
HEAT SOURCE:
Contact Person
Name: k/Oj Ar/farn 7d'i
Dg- t
Phone:
Describe the scope of woric in detail:
frf/Acc.
Contractor:
DIMENSIONS:
- - ,
# OF STORIES:
Name:
MAIN FLOOR TO SQ.
FTG:
2Nu FLOOR SQ. FTG:
Address:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
City:
State:
Zip:
Phone:
Fax:
HEAT SOURCE:
Contractor Lic No:
Exp Date:
City Business Lic. No:
Cost of Project: $ jrre
Proposed Use:
**************The following MUST be complete: write N/A if not a licable **********************
HEIGHT TO PEAK:
DIMENSIONS:
- - ,
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2Nu FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DECK/COV, PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that: 1) If this 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) 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) This City of Spokane Valley Permit is not a perrnit 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.
SIGNATURE/c4Jlacy7/9-E0-) DATE:
Method of Payment:
0 Cash
Bankcard #:
Authorized Signature:
REVISED 2/15/07
0 Check
0 Mastercard
Expires:
0 VISA
VIN#:
-0 7