2012, 04-23 Permit App: BLd-2012-0458 ResidenceOahe
..f: Valley
Community Development
Pem-at Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
\v\vw. spokanevallev.org.com
Residential Construction
Permit Application
13Lb— 2.0 12 — Oct r8
PERMIT NIJMBER:
PERMIT FEE:
(New Construction
❑ Addition/Remodel
o Other:
o Accessory Bldg
❑ Deck
SITE ADDRESS 1124 N•laset6 ��CI
ASSESSORS PARCEL NO: 5o 73 . 2 sg S LEGAL DESCRIPTION: I to rQ M ecicl oW5 Lai- 15 1311(2
4
Buildiweer
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Name: D s ct rvt,z,„c(
R-0 C X
Girt, s 1
Address:
IMPERVIOUS SURFACE
AREA: v
4
FINISHED BASEMENT
SQ. FTG: ,�
City:
Zip:
30% SLOP ON
P
PROPERTY: 14I/,4
Phone:
Fax:
HEAT SOURCE:
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Contact :Person
Name: F -Lk
Phone: 'Zl''
Describe the scope of work in detail:
3011 3 (_ Li S i
trito
_on acr .
Name: t41,1frthrtt;i I -o( /e (r_,,,iS 1”
Address: 2...6 tr P. -- viIi'v'e,.v1 41/1
City: E;,14 l==ei Az f i= I L Zip: t/C(j 7 if
Phone: 'Z.,.- - - ' ,: 11 Fax: (1 7..-6,„ - ke `i'
Lic No: Exp. Date:
City Business Lic No:
Cost of Project:
$ / t, 600
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS: v, ��,
# OF STORIES: ,
TOTAL HABITABLE SPACE:
zogig
MAIN FLOOR TO SQ.
FTG:
f C 6
2Nu FLOOR SQ. FTG:
e
UNFIN BASEMENT SQ. FTG:
s l i
IMPERVIOUS SURFACE
AREA: v
4
FINISHED BASEMENT
SQ. FTG: ,�
GARAGE SQ. FTG:
e- '7 S-
DECK/COV. PATIO SQ. FTG:
/ c
30% SLOP ON
P
PROPERTY: 14I/,4
# OF BEDROOMS:.
nun". ,,...�..
CONSTRUCTION TYPE:
V 0 _
HEAT SOURCE:
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SEWER OR SEPTIC?
Jt�-t,�`c'._
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 application can be processed.
(—) (-1
Signature 4�
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
Date L/- Z 3 -/Z
❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
❑ Other
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