2014, 05-19 Permit App: BLD-2014-1126 Pole BuildingSpokane'
FValley°
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@sookanevallev.orq
(Staff -Use -Only)
{%R61 EFI(`(uMBER:J ��O' I
PERMIT FRP Q`EIVED
MAY 19 2014
RESIDENTIAL CONSTRUCTION PERMIT APP tb- NTER
Li NEW CONSTRUCTION Q ADDITION/REMODEL [1 ACCCE
DECK _ Q OTHER
SITE ADDRESS: A - n
9ao F. [ J°syy')rtf Com
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: [�� /� ��. "7 ( $t_
J��-
NAME: ( -,�/J l a S`C�ifrY I� —
ADDRESS: (9. / ail aC) 10eS Mel 1 IA( _
CITY:
PHONE:
eipqt L»
&(.
fls)e_•
CONTACT NAME:
FAx:
Y_BUILE6Ifi6
c4'/ x io fD15 bcu l�Pr�1.
STATE:
cog ZIP: q / „2*
CELL:
She _
PHONE:
efI YYl f�
FAX: CELL:
CONTRACTOR NAME: cj Ione .{P;
MAILING ADDRESS:
Cm:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
c/)(/) j9i /r LCc//Cd
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Heigiht 9 Peary/ /
JJ 1 to +`
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:
7;2-0
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
300/0 Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ % 7�/ , T/
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 mai be reto be submitted and subsequently approved before this application can be processed.
Signature
Date: 6.--,_40--/3/
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
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