2007, 09-12 Permit App: 07003606 Handicapped RampsSpokane
jValley=
Community Development
Residential Construction
Permit Application
Pernut Uenter
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
SITE ADDRESS: 8 I Z 2.
PERMIT NUMBER: � (-; C;
PERMIT FEE:
New Construction Accessory Bldg
ht>5.---- _ Addition/Remodel Deck
Other: ?4 M pS
, C7race , S2o1C2fc, Lia WA
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building Owner: Jcrrq 4-- 4.1 r►� u Ri n f / C tr
Name: CJcrr.(11 pin i. / C r.
Address: / Z. Z 2,G V ac-.
City: Sr okOne i a / 1 State: toA_ Zip:
r V �1/
Phone: 2 / 6 q 5` y 7 Fax:
Contact Person
Name: (% Crlr 1 l n thy
21G q5 ki
Phone:
Describe the scope of work in detail:
Contractor:
Name: T/M,JF CL /4/aL Cons- 7-7 Inc
Address: 6,,,/ Z 6 z
City: ni. eaA. State: Mg Zip: %9UZ/
Phone: 2( y G ZZ c/ Fax:
Contractor Lic No: Thio. e H,T9Eo ME(pa Date: 7_ i 2 _Zoo 3
City Business Lic. No: £ j/ f 4 3 5 (� 7
Cost of Project: $ 4- /(Q C = t
Proposed Use:
**************The following MUST be complete : (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS: i
: . STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2"" FLOOR SQ. FTG
FI BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DE' 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 prop ow r r or has permission to represent the property owner in this transaction. 4) All construction is to be done
Spokane Valley Permit . ent r.,/ 5) T
in full compliance with t e Ci rpt Spokane Valley Development Code. Referenced codes are available for review at the City of
of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordihande. 6) P r additional information may be required to be submitted, and subsequently approved before
this application cap [7,1,e pre ed.
SIGNATURE: y) DATE: /2. D 7
Method of Payment:
0 Cash 0 Check Mastercard 0 VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/15/07
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