2012, 03-12 Permit App: BLD-2021-0134 DuplesCommunity Development Department
Permit Center
Sprague
SUNOF �% � 11703 East Sprague Avenue, Suite B-3
pokane Spokane Valley, WA 99206
Tel: (509) 688-0036
Valley Fax: (509) 688-0037
40015
permitcenter@spokanevalley.orq
(Staff Use Only)
PERMIT NUMBER: e 3
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Egi NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK 0 OTHER ++�� //
SITE ADDRESS: , as 17 -ox C.C�U , �4Okde- Va U iA 'i ) 0
ASSESSORS PARCEL NO.: liSOel ►- pi Ig, LEGAL DESCRIPTION: /
BUILDING OWNER NAME: \J, k.1( Dt' (,^/I til
NAME: V, kai �.T/iG(lN%-cis
ADDRESS: 9 ) `I w 0101„,t,
CITY: f4,C )tA A!!2
STATE: Vu �J
PHONE:
10-
FAX: CELL:
ZIP: 1 lia4
CONTACT NAME:
PHONE: ISIQ 9) 7 / 0 Ci ` d FAX: ,1 lett_ CONTRACTOR NAME Ow ►✓ � I� 1'24 , 1 �t-e�
CELL:
MAILING ADDRESS:
r3 (d /Z /3t
Crry:
I_
PHONE:
AX:
CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DEACRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
H p1 e -}t Ko bL bk Lir.c� ►�S �iS fx +2ni-rz I hit Nir_sL
IPNif C w tJL
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: ,
Dimensions: j� ` x G I
y
No. of Stories:
Total Habitabl S ►=
Space: 1 7
Main Floor SQ,.
FT: 65 b sr
Upper Floor SQ FT: �;-
Tfinished Basement
Finished Baseme Q
FT: i./ it
Garage SQ FT: „F
,� t 1
Deck/Covered Patio) Q
FT: N /11'
Impervious Surface
Area:
30% Slopes on
Property: 17 �u
No. of Bedrooms: 3
Construction Type: $ ;i- :
Heat Source: Gtr y
Sewer or Septic: Sr k,Y-n--
TOTAL COST OF PROJECT: $ /4 7 , rZ'O
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 thi City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the rope owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Ref rence Codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a per it or ppro a(' for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be bmi d a d Subsequently approved before this application can be processed.
Signature
Date: 31 01 I
Updated 1-11-11 Page 1 of 1
http://www.spoka neva Iley.org/filestorage/124/938/210/948/1496/Building_Permit_-_Residential_11-11-11.doc
•
54D4'
I ra
�.� 12
ft. ---t4
1
,)3,301
-t21)41-1
"_i
1
I_
•
i Ol %GF
1 �
-itOltfr- -
I
DLA PE
PM706EP ROSE LOCATION
2122 N. FOX LN.
1
1
•
1
•
r
<14
i
R
1
•
-O
lo,94
y'1zz
/FOX W.
a18..- 1Z -
I
LU
3N/I N 1