2012-04-23 Permit App: BLD-2012-0457 ResidenceCommunity Development
Permit Center
11707 E Sprague Ave, Suite 104
Spokane Valley, WA 99206 �'lTY OF SPOKANE VALLEY
(509)688-0036 FAX: (509)688-0037 APR
www.spokanevalley.org.com
Residential Construction
Permit Application
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PERMIT NUMBER:
PERMIT FEE
ruction ❑ Accessory Bldg
o Addition/Remodel
n Other:
o Deck
SITE ADDRESS I RZO N. Cc H Dr.
ASSESSORS PARCEL NO: 5513. 4 LEGAL DESCRIPTION: Lo /6 L / f.. Z Flof-c i ed S
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Name:
PiAv►,oAc Z.4„,C, k ccv,s t
Address:
Phone: 92'/ - y q (.> y Fax: 9 Z 6— g 0 lc/
City:
Zip:
Phone:
Fax:
ersi
Name: 170 4.0,, \
Phone: 2 % % - '1 9 Z. (-4
Describe the scope of work in detail:
Build G lotto SF e
u�
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Name: �TG.kro, ,J Ince K (cos1
Address: Z6,0Z /V. Su)I/Vart
City: S,L k4 eVL Vet 1 le y Zip: 9? -V b
Phone: 92'/ - y q (.> y Fax: 9 Z 6— g 0 lc/
Lic No: Exp. Date:
City Business Lic No:
Cost of Project:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
It
DIMENSIONS:
6y x30
# OF STORIES:1
TOTAL HABITABLE SPACE:
4%1.3 /2 S3
MAIN FLOOR TO SQ.
FTG: 12 3 3
2"D FLOOR SQ. FTG:
___,
UNFIN BASEMENT SQ. FTG:
+ - O
IMPERVIOUS SURFACE
AREA: Nip.
FINISHED BASEMENT
SQ. FTG: 449.
GARAGE SQ. FTG:
LINO
DECK/COV. PATIO SQ. FTG:
100
30% SLOPES ON
PROPERTY: NO
# OF BEDROOMS: 3
CONSTRUCTION TYPE:
Wood Fri wm.
HEAT SOURCE:
N o.txtrc•1 C&a.s FwY &LQ
SEWER OR SEPTIC?
52t,v-e.,r
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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 applications be processed.
Signature
Ccs
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
z3 -/Z
❑ Other
Authorized Signature:
REVISED 8/25/2005
PLANNING DEPT. APPROVED