2005, 12-08 Permit App: 05004618 RemodelPermit Center
S Okane 11707 E Sprague Ave, Suite 106
... Valle Spokane Valley, WA 99206
Y (509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.org.com
Residential Construction
Permit Application
RMITNUMBER.,::
:.PER VII
o New Construction
o Addition/Remodel
o Other:
73.76
o Accessory Bldg
o Deck
SITE ADDRESS z4Z
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Name:
Phone:
Describe the, scope of work in detail:
DIMENSIONS:
2 -i y 4.nU
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Ly'iviTj. ?, _...4.-----k-
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Name:
Name:`-(
2"" FLOOR SQ. FTG:
..-c. D L S 7—"--0
Address: ; y 2k, 1 cit..
,,.
City: S- V • Zip:
; i 2 O 6
Phone: `7 ? - 2 l Fax:
City Business Lic No:
Name:
Phone:
Describe the, scope of work in detail:
Cost of Project:
T L o h ri.7)1' �.
b� � La,
$ 3oo
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
I4,
DIMENSIONS:
2 -i y 4.nU
Name: s E G F
TOTAL HABITABL SPACE:
q-y0v
Address:
2"" FLOOR SQ. FTG:
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
CONSTR CTION TYPE:
Cost of Project:
T L o h ri.7)1' �.
b� � La,
$ 3oo
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
I4,
DIMENSIONS:
2 -i y 4.nU
# OF STORIES: -t
1 er-,... (
TOTAL HABITABL SPACE:
q-y0v
MAIN FLOOR TO SQ.
FTG:` .,.}
4 ZL�C/ W
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG: Z,-� it
GARAGE SQ. FTG:
fl'—,6J-tp
DECK/COV. PATIO SQ. FTG:
-1-- 0-v 0.
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
imic+w1 w I e�
CONSTR CTION TYPE:
HEAT SOURCE:
�ci0 Tj T
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
n be processed.
Signature
Date t Zfr/vf
Method of Payment: (Fazed permit applications will only be accepted with majo ba kcard)
0 Cash 0 Check ❑ Mastercard VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 625/2005
0 Other
NEC
NEC Unified Solutions, Inc.
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