2012, 12-26 Permit App: BLD-2012-2297 Repair Fire DamageSpokane.00Valley.
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
DermitcenterPspokanevallev.orq
Project # lei -1 Z- 2217
(StatIRE E4)V E D
PERMIT NUMBER:
DLL 2 6 2012
PERMIT FEE: /7l,
7 X
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SUB #. I7j REV. #
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION
El DECK
SITE ADDRESS: 'J p&O kV
ASSESSORS PARCEL NO.:
[] ADDITION/REMODEL El ACCESSORY BUILDING
M OTHER - Re7ccr
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: AO,
ADDRESS:
Q/a( Ah
2O ; (6-‘//
/7/,e,/
PHONE: f6 <7735
CONTACT NAME:
STATE:
zip: 1707/6
FAX: CELL:
PHONE: 5414 -e FAX:
CELL:
CONTRACTOR NAME: ( ' �� 4h &te) a'L
MAILING ADDRESS: oaf/ 7 t- ,c/S'.,S
CITY: s;//r�. �
PHONE: /(� qp (J /
/STATE: �g ,
FAX: y67" S-oD
�
zzIP: ••• 0,2a
/
CELL: /357�2
CONTRACTOR LICENSE No.: (# x,57(«bis EXPIRES:
CITY BUSINESS LICENSE NO.:
DES RIBE Tj-IE
i>11,-(1_5
OAWORK L �NDINDICATEJJSE,80PR9POSED USE:,
/at--,0,4°ee-i ,far.5eti'oe<Ao� Zel - //
s7t SeV j -a7 4rsipicl e2l'It71/W
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****YOU MUST COMPLETE THE FOLLOWING****
RK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
4Dd
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: /2 -27-
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