2015, 04-08 Permit App: BLD-2015-0772 ResidenceFax: (509) 688-0037
esionalleya permrtcenter(thookanevallev orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
:_NEW CONSTRUCTION 0 ADDITION/REMODEL D ACCESSORY BUILDING
• DECK . 0 OTHER
SITE ADDRESS: lel cos E. eemcm..30"- A-ucr
ASSESSORS PARCEL NO.: 55b61. /ea/. LEGAL DESCRIPTION: SF Acw.s.
BUILDING OWNER NAME: pyryppy ijoescs
_ _ NAME: ti (jet eAy 1-3/4 0 if\ e. 5
ADDRESS' : 2.4 bLi 7.10. c, I 4 PL Su;tt_ 110
Cry: c<tGlYnor-ei
„„E: %LI - G6 07
STATE:
og.
Fma
CELL:
CONTACT' NAME: O/IAS 1?0810
PHONE: 5r37 itt/9 °sag FAX: 1)
CONTRACTOR NAME: 5 al /*NO._ C1 5 CI boVe-
MAILING ADDRESS:
Cry:
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:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT_ APPLICABLE
Height to Peak: ti,6
_Omens:ten:Fr-go,. ic-6-0.
_No. of Stories:
-Main Floor SQ FT:
Upper Floor SQ FT:
MP,
Dnfinished Basement SQ -
Total Habitable
Space: /579
Finished Basement SQ
Ff:
-Garage SQ FT:
Deck/Covered Patio SQ
Impervious Surface
-300/0-Slopes on
Property:_
No. of Bedrooms: 3
Construction Type: gas
Heat Source: GikS-
TOTAL COST OF PROJECT: $ ,000
Sewer ar Septic: SEweiz
.the permitted vedflesracknowledges and agrees by their signature that: 1) If this permit is for construction' or on a dwelling, die dwelling is/will i
__..beserved.by.potable.water.-2)-Ownership-of.this.CIty.of.Spokane Valley.perrnit.inure to the property owner73)-The signatory'ls.the property--
- - —H-OwPei-ibir-lfas:pqrrnisSion:to5representthe,pFoperty.owner In this transaction.-4)-AWconstruction-is-to-be-done'ln-full-compliance-withthe-City uf--
§pOkene valley DeceiePinent 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.pernitt or,approval for -any -violation of Federal, state or local laws, codes or ordinances. -6) Plans or additional I i
information -may be required to be submitted -and -subsequently approved before this application can be processed.
.- ...- --Daie :_ii/Z-b C___ ___ ____
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fSignattire
Updated 1-11-11
- - - - -C: \Users \ mmoore \Downloads \ Res_Permit.doc
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