2012, 09-12 Permit App: BLD-2012-1474 ReroofSfilikane
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
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@sookanevalley.orq
0 NEW CONSTRUCTION Nts ADDITION
0 DECK 0 0
SITE ADDRESS: ___S-- /64,2/ C/ii471-6 kr 76
ASSESSORS PARCEL NO.: LEGAL LEGAL DESCRIPTION: / 74 /0 ,E/iE '7
BUILDING OWNER NAME: --"fge&de
0 ACCESSORY BUILDING
NAME:
ADDRESS:
CITY:
PHONE:
/it
5. / .01‘/
SADI Ver
CONTACT NAME:
PHONE:
CONTRACTOR NAME:
Xi)
STATE: 4)4- z :
MAILING ADDRESS:
CITY:
PHONE:
CONTRACTOR LICENSE No.:
Fax:
CELL:
FAX: CELL:
STATE:
FAX
CELL:
C.)
EXPIRES: CITY BUSINESS LIcfrNSNO.:
DESCRIB THE SCOPE OF WORK IN DETAIL ANDiINDICATE USE & PRp
Oi4 et,t'ctj %En/ 7/1.5-7 -71--yvs s Xer,
****YOU MUST COMPLETE THE FOLLOWING****
A IF NOT APPLICABLE
Height to Peak: 4
Dimensions: /
3lf Xj.,
No. of Stories:
Total Habitable
Space:
Main Floor S •
Upper Floor SQ FT' 4
Unfinishey7ment SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
hil
Deck/Covered Patio SQ
FT: A
ImperviouiSurface
Area:
n
30% Slopes on
Property:
C
•/-0-0 5
No. of Bedroorgs:
Construction ype:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
5 -ca) c°1
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
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_-__Residential_11-11-11.doc