2012, 01-17 Permit App: 12000119 RampCICLTYOF
pokane
Community Development Department
Permit Center
11703 East Sprague Menue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@sookanevalley.orq
(Staff Use Only)
—f
PERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
fl NEW CONSTRUCTION Li• ADDITIMREMODEL 0 ACCESSORY BUILDING
jj DECK WOTHER
SITE ADDRESS: for Ajoicve 4o Kg nt )IN,
N
ASSESSORSPARCEL O.: y-5—eppz /0 (lc) L LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: 3 1 nnonr D Vvokr-t2
ADDRESS: 18(AID 1 E)LitiKt-q(7,
CITY: 0_1(,,irr' KtilrLi STATE: t U(l_J Zip: 9C/Cc)-77
PHONE: bOq q2_7 p751 FAX: CELL: q)9 -1 I 0 zHcil
CONTACT NAME: Linda Lc -inn() ullYCT--
cPcw NiP VI' I CY
PHONE: irq Or/ 3705 FAX:
CONTRACTOR NAME: 6--c, 41,-, tj 11
MAILING ADDRESS:
Eox
CELL: •
CITY: [Jedify STATE: LL/A
PHONE:
C7.'9L 75- WS" FAX: 7/ --)) (Y. CELL:
CONTRACTOR LICENSE No.: (co I 6-C(DEA: g(c° qg 'Mil
PIRES: , CITY BUSINESS LICENSE NO.
99c
crc/-
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
Tpovy L. WAecic)-o LK' c,ip ir ica.Z/e c/1 en
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: ADimensions:
No. of Stories: it )
Total Habitable
Space:
Main Floor SQ FT: i\r)
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ or
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) AU 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
21e
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.orgifilestorage/124/938/210/948/1496/Building_Permit_-_Residential_11-11-11.doc
If+ ma -to oropc
AaTIVA -Nv)i'0-:-1(3 JO A.110
/7
R AS on Car v,rek 02.
(,rz.
cono-tf-ei
co.) N oic)_S
-19
-V9
4/1
CflY OF m»AF VALLEY
th
\C
-
7,746FToul-0 —r
p6S4
I t.
11