2015, 01-07 Permit App: BLD-2014-0024 Kitchen, Pass-throughSpokane
Valley
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
permitcenter@spokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
0 NEW CONSTRUCTION ADDITION/REMODEL 0 ACCESSORY BUILDING
111 DECK ❑ OTHER�,r� p�
SITE ADDRESS: 7' (��/ Project ,--1W)3�/ 15 VQ
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: RECEIVED
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT ❑):
NAME:
ADDRESS:: -NA
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CITY: " x7c V W. 'V a2 ,iD
PHONE:
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STATE:
CSV 1IT CENTER
SUB = ZIP: RE\/,
FAX: EMAIL:
CONTACT NAME:
PHONE:
FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT II:
MAILING ADDRESS:
CITr:
STATE: ZIP:
PHONE:
FAX:
EMAIL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DECRIBE THE 4 SCOPE OF WORK IN DETAIL AN aNn A. & PROPOSED USE: aaA
****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:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
Soo
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 re uired to be bitted and subsequently approved before this application can be processed.
v, / i1 I � 7 / / '2 / l
Signature/
Updated 12-1-14
Page 1 of 1
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FILE
Project
RECEIVED
JAN 0 7 2015
CSV PERMIT CENTER
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