2015, 05-08 Permit App: BLD-2015-1055 Addition, GarageO
Spokane e
doo.Valley.
RESIDENTIAL
NEW CONSTRUCTION
DECK
SITE ADDRESS:
ASSESSORS PARCEL NO.:
Community Development Department
Permit Center
11707 East Sprague Avenue, Suite 108
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
permitcenter@spokanevalley.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
Project # �.=,Dt LO`
RECEIVED
CONSTRUCTION PERMIT APPLICATION
'•Ini u u [UIJ
ADDITION/REMODEL ❑ ACCESSORY BUILDING
ET OTHER
CSV PERMIT CENTER
P 1 In a rn
LEGAL DESCRIPTION: (—�___I city. #
OWNER/APPLICANT (CHECK eox, IF MAIN CONTACT ❑):
NAME: 4 t:s 6y
ADDRESS: 7qZ L • `-�c•/J•r/V- atCo 79 re_ �j p
CITY: Sl /�3O%/ ,LZ `. V Al 7 ��Cy STATE: 2-4 zip: / 2/ a
PHONE: /// Q) 25/-3 g 0 8 FAX: EMAIL: 4 /e/ OB til /�
$-7 & q
CONTACT NAME: 6- f -Cf
PHONE:
FAX: EMAIL:
CONTRACTOR NAME (CHECK Box, IF MAIN CONTACT FI):
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****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
2j Z -O 4 72.
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Il/
Deck/Covered Patio SQ
FT:
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 perrisssion to represent the property owner In this transaction. 4) All construction Is to be done In full compliance
with the City of Spokane V alley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5)
The City of Spokane ValI -permit is not 6,.permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans
or additional info ation ay pe require to be submitted and subsequently approved before this application can be processed.
Signatu
Date: '5^ g •lf