2013, 07-16 Permit App: BLD-2013-1397 WindowSiblone
4nalley`
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( P397
Project ��l� —1 310
RECEIVED
Community Development Department (Staff Use Only)
Permit Center JUL
11703 East Sprague Avenue, Suite B-3013 PERMIT NUMBER:
Spokane Valley, W5 992 6
Tel: (509 688-0036.b V PERMIT CEN1 EPERMIT FEE:
Fax: (509 688-0037
permitcenter@spskanevalley(orai REV. r
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION
0 DECK
SITE ADDRESS:
1-3 F
ADDITION/REMODEL 0 ACCESSORY BUILDING
D OTHER
F2 1_ t C 14Oe
ASSESSORS PARCEL NO.: '-15 04 2
Jo�l
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: I-Ie.,U; I Chi-e-rn5
ADDRESS: 11 7 t Z CE e. of SCfr-
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CITY: J �iGi (�["�L� 141.11
L�
PHONE:
3r- 5 `»/3
STATE: W/, ZIP: 9 1 D u 6
FAX: CELL:
CONTACT NAME:
PHONE:
FAX: CELL:
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 S & P O /POSED USE:
Pui & flI0 w1 i /1 olo ors `I -s:: rS nil 57? /. c✓c- Ind t -5t
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
TOTAL
Dimensions:
No. of Stories:
2-
Total HabitaDIe
Space: 00
Main Floor SQ FT:
1. ZOO
Upper Floor SQ FT:,Unfinishg
N//"
Base nt SQ
FT: 'j
Finished Basement SQ
FT: J / / ca
Garage SQ FT:
G, 7
Deck/Covered Patio SQ
FT:
Impervious Surface
Area: Ni/L
30% Slopes on
Property: ,✓//h
No. of Bedrooms: 3
Construction Type:
Heat Source: SOS
Sewer or Septic: Se--'1-1—
•-^"T
TOTAL COST OF PROJECT: $ BOO, OO
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 to h ubmitted and subsequently approved before this application can be processed.
2L/141) r C)Oi3
Effective October 28, 2007 (� Page 1 of 2
P:\Community Development\02 Administration\03 Forms - 0ffi I Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
Signature
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d\in. V_ P Lt
Method of payment: ❑ Cash
Bankcard #:
Authorized Signature:
0 Check 0 Visa
EXP:
Date: % /613
❑ Mastercard
VIN#:
Effective October 28, 2007 Page 2 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
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