2015, 01-20 Permit App: BLD-2015-0097 RemodelSptiikane
!Valley%
Community'DeveI5ptnent Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
permitcenteitsookanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 ` NEW CONSTRUCTION ] ADDITION/REMODEL ESSORY BUILDING
0 DECK fl OTHER
n Project
SITE ADDRESS: V I I i � • � I.V''�� � t�f �"/
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: C E I V E D
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT ❑):
NAME: 'i)
ADDRESS: f%( /I/4 9
CITY:
PHONE:
JAN 20 2013
C�QIP:V PERMIT CENTER__ I
STATE: I REV
FAX: EMAIL:
CONTACT NAME:
PHONE:
FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT
MAILING ADDRESS:
_)�h n f��InGZn i iUY�
Il2 t. ffsc± ?eJ
CITY: 5-Fk—b -\C STATE:
PHONE:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
ZIP:
96/229
FAX: EMAIL:
DESCRIBE THE SCOP OF WO K IN DETAIL AND INDICATE USE .& PROP SED USE:
e, ,et r�, aAt {> a c� tui o I� t Axi—waiY6 ((Yam I n
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
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:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
300/0 Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ 9 )QQ
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 d`be submitted and subsequently approved before this application can be processed.
Signature
Date:
Updated 12-1-14
Page 1 of 1
1
5vvvikL t?7c
I- 1
kri
FOR CODE COMPLIANCE
LLEY BUI ING • •
;MI
Project
RECEIVED
JAN 1 0 2015
CSV PERMIT CENTER
V.
111