2014, 10-02 Permit App: BLD-2014-2378 Roof Addition*Wane
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Community Development Departmentprojec1 # (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 F'ieRai lENj*E0 ;-�./
Spokane Valley, WA 99206 134-'
Tel: (509) 720-2540 PgfirOFE
Fax: (509) 688-0037 II
perm itcenter@sooka neva I lev.orq
CSV PERMIT CENTER
RESIDENTIAL CONSTRUCTION PERMIT APPJIO TI
ON
Ei NEW CONSTRUCTION A ADDITION/REMODEL ❑ ACCESSORY BUILDING
0 DECK /� 9 OTHER
SITE ADDRESS: 94/ 01 5 [Dene Jive 5oKo,ze
ASSESSORS PARCEL NO.: y� LEGAL DESCRIPTION:pp
BUILDING OWNER NAME: Ac L f�Sig/y.0g rt -i TSAO2
VALlPc{ wM 99)06
1-'tO0. exTQ ✓t 570-7
NAME:
KS /hog ') (41-/)g
ADDRESS: 7' o I E /SO OYr e }l tie
Crrr:
S?o/%,ne_ vMLL eS
STATE:
U/6 zip: 7 ,D 6
PHONE: S07 95-73 7,2 C. FAX: So SJ �e> 71 CELL:
CONTACT NAME: 4 (.e
PHONE:
So? 9S9'3726
FAX: 5095,5_s- 3y 7/ CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: 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:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
300/0 Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
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.
Signature v / Date: /0/ V/52
Updated 1-11-11
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