2014, 10-10 Permit App: BLD-2014-2476 Residence.000Valley.
,- rtmL. L.emer
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-2540
Fax: (509) 688-0037
Derm itce nter@ saoka neva llev. orq
RESIDENTIAL CONSTRUCTION PERM
1...._.... _.... ...••
PERMIT NUMBER:
Project - 4 ZOf LI`2�
T APPidlf D
NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCES Y 13OIMING
0 DECK 0 OTHER
SITE ADDRESS: j oZ- I E_, g,, C1SeLtjr.- v -e
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
SUB ,4
BUILDING OWNER NAME: H cit/A Q,v p rr.e/1
CSV PERMIT CENTER
NAME: H°ttdeiNi �op\t5
Z4 5.v) Cvlac:‘-. - L. Suitt ' 110
ADDRESS:
Cm: c toi 'n o
STATE:
oR. ZIP: cro
PHONE:
c L1 J c1Z3- Cb 07
Fax:
CELL:
CONTACT NAME: - M) 140, PA pb t
PHONE: OC 7 z p t '( C
Fax:
CELL:
1\
CONTRACTOR NAME: S c1 S A bovL
MAILING ADDRESS:
Cm:
STATE:
ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES:
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND I DILATE USE & PROPOSED USE:
A IIo S- -. i;u,Le. rmilc glue .r
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:,)
(`0 — /
Dimensions: )
5Zk LP
No. of Stories:
I
Total Habitable r
Space: I I-1_0?
Main Floor SQ FT:
(y
Upper Floor SQ FT: Nr,
UUTnfinished Basement SQ
1vP%
Finished Basement SQ
FT: nr A
Garage SQ FT:
GI1
Deck/Covered Patio SQ
FT:113Area:
Impervious Surface
30% Slopes on
Property: 144
No. of Bedrooms: 3
Construction Type: CCNU.
Heat Source: q S
Sew or Septic:
TOTAL COST OF PROJECT: $
80 o Cis
DISCLAIMER_
The permitted verifies, acknowiedges 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 -compllance 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
Date: /
Updated 1-11-11
C: \Users\mmoore\Downloads\Res_Permit.doc
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