2013, 05-06 Permit App: BLD-2013-0807 WorkshopCommunity Development Department ' (Staff Use Only)
'ermit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Siiiikane Spokane Valley, WA 99206
Tel: (509) 688-0036 PERMIT FEE:
Valley. Fax: 688-0037
permitcenitcenterspokanevallev.orq
Project 610_______:1 3—
RESIDENTIAL CONSTRUCTION PERMIT AF4ERWIFOrii
❑ NEW CONSTRUCTION ❑ ADDITION/REMODEL
DECK 0 OTHER
SITE ADDRESS: 4,5- 2 3 S, 1300D15
ACtdIYta[LDING
CSV PERMIT CENTER
ASSESSORS PARCEL NO.:
p'f'), .0(07 LEGAL DES
BUILDING OWNER NAME: 5/+FrtgC SPg'i.) cE
NAME: 54-pr1JC 5- Pe-Nic.;
RS Li R E V
ADDRESS: L/5?3 3 • 130talV,ES`
CITY:iU C %fi_.z`—
PHONE:
STATE:
w�
ZIP: c q v,n
FAX: CELL:
CONTACT NAME:
PHONE: Sb t1- ®Li 4 & q FAX:
CONTRACTOR NAME: -0(A)-0 la Ij2
CELL: _cog- 5'LiL+ - ItaDSD.
MAILING ADDRESS:
CITY:
STATE: ZIP:.:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE NO.:
EXPIRES: CITY BUSINESS LICENSE NO.:
THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
(At k it L- (A,Seck ctS A 56? JPi X ,,24 -
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:Dimensions:
13 . ' }-
1 t
(e K ? t
No. of Stories:
I
Total Habitable
Space: /Wig
Main Floor SQ FT: .y
433- Cf
Upper Floor SQ FT:
14Fi
Unfinished Basement SQ
FT: N fPr
Finished Base ent SQ
FT: #0 A
Garage SQ FT:
N/A
Deck/Covered Patio SQ
FT: /VA
Impervious Surface
Area: pi /A
30% Slopes on
ou JA
/Proppeerty:
No. of Bedrooms: N /f)
Construction Type:
Heat Source: n1ji4 t
eSwer eptic: AO
TOTAL COST OF PROJECT: $ /a
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 re.. r.e. o 2- s bmitted and subsequently approved before this application can be processed.
Signature
Date: 3
Updated 1-11-11 Page 1 of 1
http://www.spoka neva lley.org/filestorage/ 124/938/210/948/ 1496/Building_Permit_-_Residential_11-11-11.doc
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