2006, 02-14 Permit App: 06000455 Safety InspectSpokane
V coisoasValley
' Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-420 FAX: (509)688-0037
www.sookanevalley.org.com
Residential Construction
Permit Application
SITE ADDRESS
o New Construction
o Addition/Remodel
WOther:,
I,,lo l D, f I- eFQ l e/ e f ,4/M -
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building owner
Name: �A2L d lDoN1171- TV)ASo4%
Address: iDoi e, Freg/w4Pie/r 4 -6't --
City: *crr,my ✓ Aaiq Zip: @z6:20,
Phone: 9cY-7Cjcif/ Fax:
Contact Person_.
Name:
Phone:
o Accessory Bldg
o Deck
.(A44./,(A444.1,
.Contractor
DIMENSIONS:
Name.
TOTAL HABITABLE SPACE:
Address:
2"" FLOOR SQ. FTG:
City:
Zip:
Phone:
Fax:
Lic No
Exp. Date:
/
pity Business Lic No:
CONSTRUCTION TYPE:
Describe thescope of work in detail:
U L ,z, C s4,2f Project:
ti4Akt ` S 4, ttei 1 ,(di)LBiod frnizr. l4ted &IWOailanava ni
**************The following MUST be complete: (write N/A if not applicable)************** *******
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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 be submitted, and subsequently approved before
this application c be processed.
Signature
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash 0 Check 0 Mastercard 0 VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8252005
❑ Other