2014, 05-29 Permit App: BLD-2014-1225 Preconstruction InspectionSpokane
4,0•0Valley.
Community Development Department
Permit Center r '
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
1 NEW CONSTRUCTION 0 ADDITION/REMODEL
0 DECK 4-3-g-0 I I OTHER
SITE ADDRESS: S b! 1 ` LE�
ASSESSORS PARCEL NO.: 1.�-/-1-QL. - . �7 (�' AL DRIPTION:
ACCESSORY BUILDING
BUILDING OWNER NAME:
NAME: ge1--!i 'ky Ind /l] (
ADDRESS: rlC_ (/l J )-11---e
CITY: STATE:
PHONE: FAX:
CONTACT NAME:
PHONE:
FAX:
ZIP:
CS'✓
CONTRACTOR NAME:
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:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
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:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or 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 permissio. • -• esent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valle elopment co •- Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Va -y permit is not a per it or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
informatio may be required to be s bmitted and subsequently approved before this application can be processed.
Signatu
Date: -5/Zs/i4(
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