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2012, 05-21 Permit App: BLD-2015-1173 Addition
f161 j `V - Community Development Departmer Permit Center 11707 East Sprague Avenue, Suite 1 Spokane Valley, WA 99206 Tel: (509) 720-5240 Fax: (509) 688-0037 Dermitcenter@spoka nevalley.org Project R E Q§1-aiffVL&dDn1y) PEMA T 1BL015--— PERMIT FEE: SUB # (� REV. # 0 RESIDENTIAL CONSTRUCTION PERMIT APPLICATION NEW CONSTRUCTION (r ADDITION/REMODEL EI ACCESSORY BUILDING DECK EA OTHER SITE ADDRESS: Ra. S�nzGw (A lei G,�id ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: OWNER//APPLICANT (CHECK BOX, IF MAIN CONTACT ❑): NAME: ADDRESS' CITY: STATE: ZIP: PHONE: FAX: EMAIL: CONTACT NAME: PHONE: FAX: EMAILL: /. / / CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT FI): Jr, YJ tvv ee �J\/ Ck4-1V.ns " Vv 1 SfS�" 1 MAILINGA11DDRESS: 3378'3 !V. �sp.'� 2d• CITY: d ffidl/fL^ ew STATE: A0 ZIP: Sq-- Y,© j PHONE: Z.#Y„ZCZoy�/� 1 FAX: EMAIL: kv,Y)M.-D?xgG,d�.ea`^ CONTRACTOR LICENSE NO.: NAYV/�Z-* 8�W O EXPIRES: 7-016 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: 20 No. of Stories: Total Habitable Space: /57Ss, Main Floor SQ FT: $/ `7 o /d At., -FT: Upper Floor SQ FT: cmUnfinished Basement SQ 25 Z— Finished Basement SQ FT: A11-1 Garage SQ FT: Deck/Covered Patio SQ FT: 197 Z Impervious Surface Area: /soo � 30% Slopes on Property: No. of Bedrooms: 2 Construction Type: ,,^7J,,, Heat Source: Girs wnox Sewer or Septic: ewe TOTAL COST OF PROJECT: $ 20 k 101f - �✓ cc�-ri j ��'� 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. Sianature Date: Sl2 t l i -r