2015, 05-06 Permit App: BLD-2015-1191 AdditionCommunity Development Department Prat Sta nlv
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Permit Center
11707 East Sprague Avenue, Suite 1 8 ER NUMBER:
3CITY OF ON�Spokane Valley, WA 99206
poKane Tel: (509) 720-5240 PE0kWF&n 20b
��� Fax: itcen 688-0037 i
permitcenter@spokanevalley.org
CSV PERMIT CENTER
RESIDENTIAL CON RUCTION PE � � 0
0 NEW CONSTRUCTION ADDITION/REMODEL [J ACCESSORY BUILDING
U DECK OTHER
SITE ADDRESS:
ASSESSORS PARCEL NO.: EGAL DESCRIPTION:
OWNER/APPLICANT CHECK BOX, IF MAIN CONTACT
NAME: /S F -15h O! -
ADDRESS: SIS• a O
CITY: s��l�J� <�� STATE: 'v /�/ /61 ZIP:
PHONE: W!' 420) / FAX: EMAIL: _
CONTACT NAME: �j�/,�1�1/
PHONE:
0
FAX:
EMAIL:
CONTRACTOR NAME CHECK BOX, IF MAIN CONTACT zmla�l R� i
MAILING ADDRESS:
_CITY:'
I ' 4J®nj �Gr��
STATE: lv(/ fes— ZIP:
PHONE: ®� a� J / /F�A/X:: (iEMAIL:
CONTRACTOR LICENSE NO.: 11111,7111aO� (IakPIRES: 2CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
MARK N/A IF NOT APPLICABLE
Height to Peak: /r
Z
Dimensions:
No. of Stories:
Total Habitable y �/
Y
Space: !! dd�'
Main F oor SQ FT:
Upper Floor SQ FT.,
119—
Unfinished Basement SQ
FT: 4V&
Finished Basement SQ
FT: �'
Garage So riT
Deck/Covered Patio SQ
FT: -
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source: a
Sewer or Septic: h�'
TOTAL COST OF PROJECT: $ 7-2, 0611
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.