2015, 04-27 Permit App: BLD-2015-0920 ResidenceCommunity Development Department P oject =(Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERPTENcm Eiv
�COF-1 Spokane Valley, WA 99206
Tel: (509) 720-5240 PERMITE'
Fax: (509) 688-0037 H' "
permitcenter@ sookaneva Iley. orq
�]] CSV PERMIT CENTER
RESIDENTIAL CONSTRUCTION PER!jAPkU&TIOW =--
NEW CONSTRUCTION ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ DECK ❑ OTHER
SITEADDRESS: Id -52,0 -T—Liv C2L� _� 1
ASSESSORS PARCEL NO.: 05222.11;6o t LEGAL DESCRIPTION: '&-.oCAI-- 2 "-v-
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT [M):
NAME:2 t ---n 0 � C—tK1 C
ADDRESS: &o � � 1 jV l/�'1 L� �► t�� J \ + (� � nC
CITY: ��/kIV STATE: JA)A ZIP: - l -1 z11 J
PHONE: -I� I��� D FAX: j2Bj q ) I EMAIL: h4fw�i1P� S I�•LS-� i
CONTACT NAME:
PHONE: �� —I D FAX: l EMAIL: heW'-hee C P
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACTEI): Sm - Ls CW -u,,- 5,KW cps
MAILING ADDRESS:
CITY:
PHONE:
CONTRACTOR LICENSE NO.:
STATE:
FAX:
EMAIL:
ZIP:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N /A TF NOT APPLICABLE
Height to Peak: 2,0'/-;z
Dimensions,
='
No. of Stories:
Total Habitable
to Vk- X 3 I
Space: I I a) 3
Main Floor SQ FT:
Upper Floor SQ
Unfinished Basement SQ
Finished Basement SQ
1.1$3
mM
FT: N/A
FT: N/A
Garage SQ FT:
Deck/Covered Patio SQ
Impervious Surface
30% Slopes on
/45j�
FT: 2c5I
Area: SIA
Property: ^I/A
No. of Bedrooms: Z
Construction Type:
tHeat Source: C,,A,%
Sewer or Septic: S1FA,
TOTAL COST OF PROJECT: $ 1 So
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.
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