2015, 06-01 Permit App: BLD-2015-1269 Fire Damage Repair*Wane
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ey
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
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023+,5 u:\+,d\" P ;a
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
_DLO - 1°6-- 12.L1
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION Q ADDITION/REMODEL fp ACCESSORY BUILDING
a DECK� — El OTHER ) y� (gyp
SITE ADDRESS: ' JWJ 6, c 5 Soo Vcte o u u3ti-t l" 120(
ASSESSORS PARCE. NO.: Li %M Not t LEGAL DESC IPTIOp4-a-1•L a.a14, , 7S
OWNS APPLICANT )ccx BOX, IF MAIN`CO1NTAAC_T 0):
NAME: �-t 0 cc\O'(' l (' 1 t\ C,k ` l orn! S
ADDRESS: VO +, j. " ' r9 ov.ro ` A ` Lt t�
STATE:
Cm:
PHONE:
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Proiect #
RECEIVED
5 FAx: 5 0q
CONTACT NAME:
JUN Of -11-1,219S
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Q7 (` CtZ��IP: Y.L c�
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1 SUB =f 1 RFV =i I 1
PHONE: Q— 1 S— FAX: L z�, � EMAIL:.
CONTRACTOR NAME (cMECK scot, IF MAIN CONTACT ❑):
MAILING ADDRESS:
Cm:
STATE:
ZIP:
PHONE:
FAX:
EMAIL:
CONTRACTOR LICENSE NO.:
EXPIRES:
CITY BUSINESS LICENSE NO.:
DESCRIBE • E S OPE • F WO K IN D TAIL AND INDICATE USE & PROPO
****YOU MUST COMPLETE THE FOLLOWING****
ABLE
Height to Peak: }-
g 1
Dimensions:
(op iC —14i
of�of (or
c l-ty ii
Total Habitable-,
Space: d-1.
Main FIoy sq FT:UppePtoorSQ-
lIL1•y l\rck-SicWLi
rFT.'
Unfinished Basement SQ
FT: --1 1
Finishe&Bgsewent SQ
FT: 2SJ
4
Garage SQ FT:
Q1(1 S* v\%
Deck/Covered Patio SQ
FT: a�0 J,Li
Impervious Surface
Area:
30% Slopes on
Property:
No.—/off Bedrooms:
Construction Type:
Heat Source: (2C,k5
`Seweryi Septic:
TOTAL COST OF PROJECT: $ a_-3 , OC° OC
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 $ay be required to be submitted and subsequently approved before this application can be processed.
Signature I GC IC frtJ Y�f ti�
Date:
‘-1- 2D S