2006, 03-29 Permit App: 06001084 Siding® I CsLiU L L-Ofl Z
S akane 11707E Sprague Ave, Suite 106
.0„0:OValley
Spokane Valley, WA 99206
(509)C003- FAX: 509)688-003
�'n^
Community Development V n as. „�' r if
Residential Construcgon
Permit Application
PERIATF NUMBER: 768 t/,
PERMIT FEE: /2i9 7S—
w Construction o Accessory Bldg
ition/Remodel o Deck
er:
SITE ADDRESS 22i s. (4(.(///.d
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building owner
Name: ///s/ / &!%/1,//7 J /4 mo (
Name:
DO v C. Z /�
65
Address:
22 O c. C
e46/41)City:
/
S%�aa-/�s UAd. % Zip: 7 9027
l
Phone: `� 28-157- Fax:
GARAGE Sfi)nFTG:
Contact Person:,.
Name: 2 dt m'4pc
Phone: 99 g r 2 «5/
.Contractor:. , !,
Name: ///s/ / &!%/1,//7 J /4 mo (
Address: 6/Zo Lr -Verne,, tC
City S4/Cf�/JGs Zip: 9( Z(7
Phone: 5`35' /0 2G Fax: S3&'; 22
Lic No: OP/ Qi OalV Exp. Date: 08 /4.7a&
City Business Lic No:
Describe the scope of work in detail: Cost of Project: $ 57/2 op
/,t)s fu- ()thy z_ S/J'a , ,) , 2,i /•ckvtt!rco,J4x& daSk70_43
**************The following MUST be complete: (write N/A if nota licabl )*****
HEIGHT TO PEAK: %6- /
DIMENSIONS:
PP a
# OF STORIES: /
......
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:/2-03
2-03
2"" FLOOR
{.
Q. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
BAS�A,�ENT
FINISHEDSQ. FTG:
GARAGE Sfi)nFTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that 1) If this permit is for construction of 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 Fermi! ter. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, coded or ofd ces. 6) Pla :.. - additional information may be required to be submitted, and subsequently approved before
this application n tie,
Signature
Date
Method of Payment (Faxed permit applications will only be accepted with majorbankcard)
❑ Cash ❑ Check 0 Mastercard 0 VISA
Bankcard #: Expires: _ VIN#:
Authorized Signature:
REVISED 8/25/2005
0 Other