2014, 09-17 Permit App: BLD-2014-2220 Residence.o.OValleyw
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-2540
Fax: (509) 688-0037
permitcenter@spoka nevallev.orq
Project #
PFCFIVED
Staff`g'Only)
7 �,i
PER UMBER:
CSV PERMIT CENTER
SUB # JT REV. #1
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
IN NEW CONSTRUCTION ❑ ADDITION/REMODEL
❑ DECK ❑ OTHER
SITE ADDRESS:
ASSESSORS PARCEL NO.:
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BUILDING OWNER NAME:
NAME:
❑ ACCESSORY BUILDING
LEGAL DESCRIPTION:
Rive
14C 1L) 0PAL
5P
ADDRESS: .J•�' ci'IC:+1-er 1 L. Sti;te 110
CITY:
STATE:
af.
PHONE:
5L1) -1Z3- 6b67
Mi Icer ►'�/1 oore
CONTACT NAME:
FAX:
CELL:
ZIP: 1775 b
Sol— 7/y- 66Y!
PHONE: .o (- 11.1-$t77kj
CONTRACTOR NAME: I
FAX:
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CELL:
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: Zj V, Zit
Dimensions: _C7 )( 5�
No. of Stories: 1
Total Habitable
Space: / g e).5
Main Floor SQ FT•G
W.) j
5!
Upper Floor SQ FT:
�T\
Unfinishe�d Basement SQ
FT: Aft.
Finished B Bement SQ
FT: 11
Garage SQ FT:
S 05
Deck/Covered Patio SQ
FT: IIti
Impervious Surface
Area:
30% Slopes on
Property: ,Na
No. of Bedrooms: 3
Construction Type: C.ONU.
Heat Source: 9Q5
ew or Septic:
TOTAL COST OF PROJECT: $ i),000 E5t
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 subseently approved before this application can be processed.
Signature
Date: —jsc. g
Updated 1-11-11
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