2015, 05-26 Permit App: BLD-2015-1196 FoundationCommunity Development Department
Permit Center
11707 East Sprague Avenue, Suite 10
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
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RESIDENTIAL CONSTRUCTION PERivilT WL CA ION
(NEW CONSTRUCTION
0 DECK
SITE ADDRESS: / LJ.) 3 E
El ADDITION/REMODEL
El OTHER
1v]kSoLr
El ACCESSORY BUILDING
ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK BOx, IF MAIN CONTACT ❑):
NAME:
/AKA4AG�/`,'Ve1n/�
6 9q ' S _ ,2joi,
,00 Qi & `.S1'f✓c )'Oi'l
/5o9 2/7 as 99U
ADDRESS:
CITU:
PHONE:
STATE:
FAX:
,U'ZIP: if) o7
' 1
EMAIL: E4C✓f LA S( 170 Q4/31
CONTACT NAME:
PHONE:
FAX:
EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT ❑): 2T/ft/IA/kap"- ,o _cams
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: EMAIL:
CONTRACTOR LICENSE No.: 8/2e11-5 Xj jip(C ZEXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:Dimensior/s:
�s
cl1-
30 aIJI 33
No. of Stories:
/
Total Habitable
Space: /CUO
Main Floor SQF7•
PCI17
Upper Floor S T:
Unfinished Basement SQ
FT: 9DO
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
goo oo
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
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 epresent the property owner In this transaction. 4) All construction Is to be done in full compliance
with the City of Spokane Valley De - o ment code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5)
The City of Spokane Valley per is •t a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans
or additional information may :e req ed to b- • a fitted an subsequently approved before this application can be processed.
Date: