2010, 08-25 Permit App: 10002633 Repair Fire Damage•
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CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevallev. orq
PERMIT NUMBER:
PERMIT FEE:
(Staff` Use Only)
3 3
CITY (it- SPOKANE VALLEY
AUG25 1
HE? v` ITER
RESIDENTIAL CONSTRUCTION P • PLICATION
❑ ACCESSORY BUILDING
8Y:
❑ NEW❑CONSTRUCTION 0 ADDITIKIOO /R ERODEL
SITE ADDRESS: 8124 E. C keg e dye ,
ASSESSORS PARCEL NO.: Oso % A , 5-00 LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: /erch.).€-J /-'4I Ve/.50►v
ADDRESS: 01 a 4 C 6 o ckcy e 4 ve_
CITY: 5/0k9/✓('_ STATE: 11J,4 41/✓5 foi✓ ZIP: `)`l.2 / 2..
PHONE:
FAX: CELL:
CONTACT NAME: 7o y 1-1,41-1,^)
PHONE: 20 - 6,40-q035
Fax:
CELL:
CONTRACTOR NAME: fcic' 5 1 S 14 .5.19/e Riee,ictP
MAILING ADDRESS: AO( do )( 3 G d 2
CITY: )-IAI De►✓
PHONE: 2o3- 7-0.- 7734
STATE: 2 J4
ZIP: 638 35
FAX: CELL:
CONTRACTOR LICENSE No.: ,&t 77 EXPIRES: ) 01/ CITY BUSINESS LICENSE NO.:
k)e,=vt-1ic -4/c7-
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
4o4 ,`k' .0,211,1/41(1 C)eLfi. "C4 I / I /on,C , .vy f on. L
PROPOSED USE:
Effective October 28, 2007 Page 1 of 2
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****YOU MUST COMPLETE THE FOLLOWING****
Height to Peak:
/% t
Dimensions:
No. of Stories:
)
Total Habitable
Space: ,U*5"
Main Floor SQ
FT: /915-
Upper Floor SQ
FT:
Unfinished Basement
SQ FT: 79 4
Finished Basement
SQ FT:
Garage SQ FT:
Deck/Covered Patio
SQ FT: 3A U
Impervious Surface
Area:
30% Slopes on
Property:
No. of
Bedrooms: 49'
Construction
Type:
Heat Source:
545 F�.e.ez-D
Sewer or
Septic: 5e. '
TOTAL COST OF PROJECT: $ 74/ po
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
Method of payment: 0 Cash 0 Check
Bankcard #:
Date: 8 ` 2 S -
0 Visa 0 Mastercard
EXP: VIN #:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
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