2015, 03-18 Permit App: BLD-2015-0545 Wall in Basement(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
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/RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
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E NEW CONSTRUCTION c . ADDITION/REMODEL ® ACCESSORY BUILDING
0 DECK OTHER
SITE ADDRESS: Rel( (= C'NI151Z S nkovtz. VeiIPy Ct'A
ASSESSORS PARCEL NO.: 95-072-6567 LEGAL DESCRIPTION:
9921 Z
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT ❑):
NAME: JCS "I f1 eG(,yi iv 5
ADDRESS: 8II( E Coq -fide
CITU: Se kI AP.< elt
PHONE: 709 r/✓ J 'I eq
STATE:
cup zip: ?92/ a
FAX: EMAIL:
CONTACT NAME: (Te f:4"1
PHONE:
FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT n):
MAILING ADDRESS:
CIn:
STATE: ZIP:
PHONE:
FAX: EMAIL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WOJRK IN DETAIL AND INDICATE USE & PROPOSED USE:
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****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE n, •
Height to Peak:
Dimensions:
No. of Stories:
Nroject
+19IBllthe$ifabTh S'L `'
% . �/ r� Rn
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ r
FT:
t tinish&i B3's5maht SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
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No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:__ _
TOTAL COST OF PROJECT: $ t 00
• SUti t FitV. DT -
DISCLAIMER 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 thls City of Spokane Wiley 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 p- approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans
or additional Information may betequir� I-�• -'tted and subsequently approved before this application can be processed.
Date: — /8 (4 -
Signature
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RECEIVED 41-9
MAR 17 2015
CSV PE -MIT CENTER
MAWR) FOR 000E COMPLIANcE
8- • VALLEY SLALOM
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