2015, 03-12 Permit App: BLD-2015-0491 Pole BldgSpokane
.0•0Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
ermitcenter;asp ok3nevaiie .arc
(Staff Use Only) . _.
PERMIT E4LJt4BER `s
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL [ACCESSORY BUILDING
0 DECK 0 OTHERnn
SITE ADDRESS: ./9/S S 6;11J (rJ�9 y 6561
ASSESSORS PARCEL NO.: cf 4/0 c f L., 1- /4 LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT ❑):
NAME:
Ago) Aa A 7 t -
ADDRESS: 19`6 s' G% (lis (ADA
CITY:
PHONE:
she �011�
8'63 - 4/959
CONTACT NAME: H eL A)
60.
FAX:
STATE: II ZIP: JZ -OL
EMAIL:
PHONE:
FAX:
EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT[iie 5-PGG/Q./1 / STAG-CTUre$
MAILING ADDRESS:
//S 0e,2 f /1�o>yf, e c c
Sc . - ACITY: $ >" k 011 STATE: t,_)Q,- ZIP: Tf Z,)6
PHONE: e 02 / ` £,2S' FAX: 4/413- 35 - EMAIL: Y le -�15 Z.1.06.koz rmc6,- . Cb"
CONTRACTOR LICENSE No.: 403 - v4L -4 $6 EXPIRES: /b/P/ 29 r CITY BUSINESS LICENSE NO.:
DESCRIBE THE SC PE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
.3uXcjo Alt bui/J; - uwJ I
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions: a / r
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:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type: Pelf ,
Heat Source:
(Sewers Septic:
TOTAL COST OF PROJECT: $ Z?. -s Q
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 Valle ermit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans
or additional information n y be requir9 ko be submitted and subsequently approved before this application can be processed.
Signature
Date: 3-11' /5
Spokane
'Ualley�
Resid- la
PAVINb ` VER
MAR 2 2015
Community D6velopment — Planning Division
11703 E Sprague Ave tq-0,t okerV� 99206
509.720.5026 ♦ Fax:I509.688.00\B• panningasp v.org
IR n [ v.
Spokane Valley Municipal Code (SVMC) Section 19.40.020.8; "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.
—OWNER INFORMATION
OWNER NAME: ,4) Cd A, s /
PARCEL #: yy o y a 71L2 _
ADDRESS: 5 9/6 5' tj; ftis (...)qc� �'t—
CITY: �1?ok(.4. 00-0-2-y
STATE:
ZIP: Q��j�
L
PHONE:
FAX:
CELL:
EMAIL:
PART II —DETAILS OF PAVING WAIVER
1. Do you have an existing garage for parking daily use vehicles? 1 14ES ❑ NO
2. Is the proposed detached structure used for storage only? LZYES ❑ NO
3. Do you plan on using the detached structure to park vehicles? ❑ YES [ (NO If yes, then
what type of vehicles?
4. Do you plan to conduct a business from proposed detached structure? ❑ YES []'NO If so, what
is the nature of your business?
/n
PART III —AUTHORIZATION
I,(PRINT NAME) A 4i Lo nine.. n owner, 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. 1 further agree to report any change in these conditions to
the Spne Va -y Community Development Department, Planning Division, within 30 days.
Owner Si • ature
Date
PART IV — DECISION
STAFF HAS REVIEWED THE PROPOSED PAVING WAIVER ON BEHALF OF THE CO MUNITY DEVELOPMENT
DIRECTOR AND FIND THE REQUEST IS GRANTED AT / �)"a 51 i C�C
SAID D SS FOR P RMIT #:1���'"1� �/
W I ._,3__16
P� nnin ivision Staff Signature Date
Created 6/27/11
Page 1 of 1