2014, 05-21 Permit App: BLD-2014-1151 Decka
NAME:
ADDRESS: C � % q All :22
V q4� 44q
CITY: SLn1 % �C 1 / ,A A, O I ®1 II/✓i'/1 STATE: 1A //A- ZIP:
PHONE:
CONTACT NAME:
PHONE:
CONTRACTOR NAME:
MAILING ADDRESS:S
TATE: ZIP,;CITY:. <V41 AAA o 1/d. L 101A IAk r-ra'4
PHONE: r/9l^1 �'S��- FAX: CELL:
CONTRACTOR LICENSE NO.: -
EXPIRES:
CITY BUSINESS LICENSE NO.:' -
DESCRIBE THE SCOPE OF WO.RK IN DETAI4AND INDICATE -USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A TF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
'
Community Development Department
jefft#ff Use Only)
Space:
Main Floor SQ FT:
Permit Center
Unfinished Basement SQ
Finished Basement SQ
_
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
rPEPM.T
( t jtTSpoe
vG
FT:
Garage SQ FT:
Tel: (509) 688-0036
IT FEE:
30% Slopes on
w
VOIeyFax:
688-0037
permitcenitcenter@sookanevalley.org
AV j
Property:
No. of Bedrooms:
Construction Type:
CSV PERMIT CENTER"
Sewer or Septic:
RESIDENTIAL CONSTRUCTI®N PERMI
P
NEW CONSTRUCTION
ADDITION/ REMODEL
ACCESSORY BUILD -
MG -DECK
OTHER
SITE ADDRESS:
ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME:
ADDRESS: C � % q All :22
V q4� 44q
CITY: SLn1 % �C 1 / ,A A, O I ®1 II/✓i'/1 STATE: 1A //A- ZIP:
PHONE:
CONTACT NAME:
PHONE:
CONTRACTOR NAME:
MAILING ADDRESS:S
TATE: ZIP,;CITY:. <V41 AAA o 1/d. L 101A IAk r-ra'4
PHONE: r/9l^1 �'S��- FAX: CELL:
CONTRACTOR LICENSE NO.: -
EXPIRES:
CITY BUSINESS LICENSE NO.:' -
DESCRIBE THE SCOPE OF WO.RK IN DETAI4AND INDICATE -USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A TF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
Finished Basement SQ
FT:
FT:
Garage SQ FT:
Deck/Covered Patio SQ
Impervious Surface
30% Slopes on
FT: eJ a��
Area:
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 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. >
Signature �jti Date: 5"-%—/ y
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_ _Residential_11-11-11.doc
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MAY 21 2014
CSV PERMIT CENTER
SUB # REV. #:l::Q
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Project # —26/q r
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. MAY 21 2014
CSV PERMIT CENTER
SUB # REV. # E
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