2015, 05-28 Permit App: BLD-2015-1226 Residence(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
Spokane
Valley.
Community Development Department
Permit Center
11707 East Sprague Avenue, Suite 108
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
permitcenter(sookanevalley.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
I1 NEW CONSTRUCTION ElADDITION/REMODEL InCCESSORY-BUIL-DI•NG
❑ DECK f Q �y EI -D
OTHER Project # e-d0j5"Ia2�o
SITE ADDRESS: II o p e' 7'(Yi FT,'"=WMn
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK Box, IF MAIN CONTACT ❑): I MAY Z 8 2015
NAME:/ I l,/ ,(I /��,, 1 CSV PFPMIT rEnr-rco
ADDRESS:
{'�j//08 CI E V 7Tr' �WV/{� 1 CI IP (1 --. _
CITY: i/
J JKaj(/)Q VWIl STATE: /gZIP� 9-,ggi
PHONE: .50() 0q55 -668
CONTACT NAME:
FAX: EMAIL:
ciA( 9.610 Zoo
PHONE:
FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT ❑):
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX:
EMAIL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
11 37
/
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
39Q
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
'
Construction Type:
Heat Source: t7'i-r�>
Sewer or Septic:
TOTAL COST OF PROJECT: $ 80/ COD , 00
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 V/I�Gt -illy Ae5ocy
Date: 05;o78 1-5—