2006, 02-15 Permit App: 06000466 Wheelchair Rampa� Permit Center
Stiokane
11707 E Sprague Ave, Suite 146'<!
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 FEB 1
Community Development www.spokanevalley.org,.com ;
Residential Construction
Permit Application
'IPERMIT NUMBER: (..)--/(.0
PERMIT FEE: _13 7 C
2006
o 1V eW Construction
o Addition/Remodel
❑ Other:
o Accessory Bldg
o Deck
SITE ADDRESS
5a \ south atx-ran fL.d
ASSESSORS PARCEL NO: '1 52 3 2 • OliatLEGAL DESCRIPTION:
Buildin owner
C11
Address: 5 l , (clef- n rzzt.
Name:
City:
nY1:utvz
Phone: 90A0 -1131a Fax
Contact Person
Name: /:1_y7,L,r\cipl 120
Phone: qa t -2,� )(\:t)(452
Describe the scope of work in detail:
Contractor.
DIMENSIONS:
Name: Q( Line
TOTAL HABITABLE SPACE:
Address:
2"" FLOOR SQ. FTG:
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
CONSTRUCTION TYPE:
Cost of Project:
$ 000
c . ___�•_; r ra o-ff I A. ,rc+- . 3ib4 116 I14. _ .. o.
a�
trkaLtc,d cU at - 20 brit iAJ t'1 }rA d r is dr% fie_ aK,n S,
**************The following MUST be complete: (write N/A if not app )
licable**********************
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 processed.
n 1
Signature i.41L,t,(
r)
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash 0 Check 0 Mastercard 0 VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
-2/61040
Other
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