2012, 08-30 Permit App: BLD-2012-1467 Pole BldgSpokane
Valley
ommunity Development Department
rmit Center
703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevalley.org
III(Staff Use�yOnly) q
ERMIT NUMBER: ®3'K / I
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL kr ACCESSORY BUILDING
EJ DECK CI OTHER
SITE ADDRESS: 5 3 Z/ /lf c A) mid
ASSESSORS PARCEL NO.: z -/_,:5./c4. p //2. --LEGAL DESCRIPTION:
7
LJ f 1,O9 9f2/s
BUILDING OWNER NAME:
NAME: aG/V
ADDRESS: 5 3 1 /T4—
CITY: 7/0DK1?-14. (J z '
PHONE: SQ ?—-1 -.69 0 26/ Cc)
CONTACT NAME: 54 -/-/-
STATE: Wig
ZIp: / 97i/D
FAX:
CELL:
PHONE:
FAX: CELL:
CONTRACTOR NAME: Oct.) (\-e_
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX:
CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
?-0 X 7.D FO dr S/f V /,J 557/9 c leY/1-.e
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
ZO x ZO /C7'
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
eijo 3F
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type: y1/f3
Heat Source:
(ewerajr 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 req ed to be submitted and subsequently approved before this application can be processed.
Signature
JaieA
Date: `6/3' ?i
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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Spokane
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PAVING WAIVER
Community Development - Planning Division
11703 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
509.720.5026 ♦ Fax: 509.688.0037 • planning@spokanevalley.org
Spokane Valley Municipal Code (SVMC) Section 19.40.020.B; "All residential driveway and off-street parking areas shall be paved with
asphalt, Portland cement, grasscrete, paver blocks or other equivalent hard surface material". A paving waiver can only be granted if
the structure you are proposing is not going to require a driveway for daily use.
PART I - OWNER INFORMATION
OWNER NAME: ,.._,v,,,, 4.w GC
PARCEL #: Z' 6, 7 e/7
ADDRESS: 53 2 / ill �ti E/xG-GTE/t
CITY: ,6,e/T/v E 1)/9-4-z- e)(
STATE: W/?
ZIP: 9'92--/ 6'
PHONE: 50 - 210 -gy21
FAX:
CELL:
EMAIL:
PART II -DETAILS OF PAVING WAIVER
1. Do you have an existing garage for parking daily use vehicles? f YES ❑ NO
2. Is the proposed detached structure used for storage only? Er YES ❑ NO
3. Do you plan on using the detached structure to park vehicles? ❑ YES [r NO If yes, then
what type of vehicles?
4. Do you plan to conduct a business from proposed detached structure? ❑ YES IU If so, what
is the nature of your business?
/� PART III —AUTHORIZATION
I,(PRINT NAME) ei_, 1 E -C /"lc�Gowner, hereby confirm that the information provided on this
form is true and correct. I acknowledge that any change in the foregoing conditions, could require
the City to impose paving requirements. I further agree to report any change in these conditions to
the S . •kane Valley Co munity Development Department, Planning Division, within 30 days.
"A
Vfz
Owner Signature Da e
PART IV - DECISION
STAFF HAS REVIEWED THE PROPOSED PAVING WAIVER ON BEHALF OF THE COMMUNITY DEVELOPMENT
DIRECTOR AND FIND THE REQUEST IS GRANTED AT 53ajj
/ ,F'( /N9Pe'. le -C/
SAID ADDRESS FOR PERMIT #: tail) - p2( /? —/4j6 "7'
Plan ng Division Staff Signature
t3/ )/z
Date
Created 6/27/11
Page 1 of 1
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53.
Project #
RECEIVED
AUG 3 0 2012
CSV PERMIT p ENTER
SUB #
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