2008, 09-08 Permit App: 08003530 Final Inspect for Permit: 04001375Sti0 arm
401, Valley
Community Development
Permit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.sookanevalley.org
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PERMIT NUMBER: 5�-5O
PERMIT FEE:
Residential Construction n New Construction Accessory Bldg
Permit Application ❑ Addition/Remodel ❑ Deck
(1 Other:
SITE ADDRESS: 1/12 / ✓ `—"fg rL��n- F�
ASSESSORS PARCEL NO: 1167✓ Cf3, 0 3/ / LEGAL DESCRIPTION:
,Bnttig`:Ow,'ere,cQt :i? �T{LyI ,,i
—
:Contractors+: 4
:c3_kf3i:.7Cr?q H.,_y;
-
Name:
Name: /446.... /0N1 Lipo ,in
Address: 1 �2 / S Jao" tt)11
City: ! !/ State: Zip:
Address: /9/ SLe, p/0 it W
City: c %Q tate: w4 Zip:gLit2 �
Phone:/ q7S-7090Fax:
Phone: Fax:
FINISHED BASEMENT
SQ. FTG:
Contractor Lic No: Exp Date:
t. biff CtiP,e Situ- =lM$: SP/4 -7-47 P:iy^
30% SLOPES ON
PROPERTY:
City Business Lic. No:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
Name:
Phone: [ cog / I/ 7 C— 7090
L. /
Describe the scope of work in detail:
Cost of Project: $
Proposed Use: n.ccz 114A/2 <-i YL -
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2' FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
-
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
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 Permit Center. 5) This 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 prgpessed.
SIGNATURE:
Method of Payment:
IV Cash
ankcard #:
Authorized Signature:
REVISED 2/15/07
c�ttfEr
❑ Check
❑ Mastercard
Expires:
DATE: 05 01' 087
❑ VISA
VIN#: