2007, 10-03 Permit App: 07003959 SidingSpokane
jValley°
Community Development
Residential Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
PERMIT NUMBER: �,95 J
PERMIT FEE:
New Construction Accessory Bldg
Addition/Remodel Deck
n Other:
SITE ADDRESS: 3/ —/ 5 Cci 7'r ki
Sec 1i,-)4
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: l [-PSiekki C E'
Building Owner:
DIMENSIONS:
3o Y6 U
Name:
on .e/yerS
%
Address:
3 1 v 5 (-0.5 /Urn G+
IMPERVIOUS SURFACE
AREA:
City:
�per , State:�7
Zip:
Phone:
?s7 2 > O U`a Fax:
Phone: f3 s-_ / 7C7C, Fax:
lLic
Contact Person
Name:
Phone:
Tc. --W Pi/ e
L/ 3 S` r /COO
Describe the scope of work in detail:
/)e CG v
Contractor:
DIMENSIONS:
3o Y6 U
# OF STORIES: ,
Name: C r ts r4 C Ct ' i 9 si 4.
%
2ND FLOOR SQ. FTG:
Address: /
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
7 7
City: n StaCA.10 `
Zip:
/ i
,, ?
Phone: f3 s-_ / 7C7C, Fax:
lLic
HEAT SOURCE:
SEWER OR SEPTIC?
Contractor NoG�: Date:
r��4'CfSy3 ��ty
�e /_
�7
City Business Lic. No:
Cost of Project: $
r'o
9e/c2-
Proposed Use:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS:
3o Y6 U
# OF STORIES: ,
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2ND FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
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.
SIGNATURE:
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 2/15/07
•
❑ Mastercard
Expires:
DATE:
/o - 3--c7
❑ VISA
VIN#: