2006, 03-29 Permit App: 06001080 Sidingcn; Permit Center
Spokane
e 11707 E Sprague Ave, Suite 106
assissasVaSpokane Valley, WA 99206
11 (509)68B)$6e (i309)16$700,7
Community Development tkivw.s. M i lie rl. -com `
9
PERMIT NUMBER: epo
PERMIT FEE: .3, 75 _
Residential Construe L ❑ Construction o Accessory Bldg
Permit Application •D u i L o Q 1 tion/Remodel ❑ Deck
o O er:
SITE ADDRESS 1)/ i,7-1-1- ( 4QC,
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Builcling owner
Name- Co I S n+tR
Address:Ai . 1 3— �, n(3 .1
city: WA(/li 5 Zip: 790/ (
6R
p
Phone: Baa OW Fax: 7)3 -0 g p
Contact Person _.
Name:
Phone:
Contractor.0 _
Lel
Name.
TOTAL HABITABLE SPACE:
I -0o
Address:
21°" FLOOR SQ. FTG:
City:
Tip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
30% SLOPES ON
PROPERTY: /L C r/ C
Describe the scope of work in detail: Cost of Project: $ COO- °o -j
( �t%(n 6-X7) o Sv r>=
IhP
--k-A4 LAl► { c—
**************The following 1\NST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK: /
/Li
DIMENSIONS:
# OF STORIES:
I
TOTAL HABITABLE SPACE:
I -0o
MAIN FLOOR TO SQ.
FTG:r e O
21°" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
-
GARAGE SQ. FTG:
�j
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY: /L C r/ C
SQ. FTG.
# OF BEDROOMS:
a
MCI", AlnllcO
COAJSTRUCTION TYPE:
{ ,:✓slew,
HEAT SOURCE:.
6t.f}s– 4 L,6�ftiG
SEWER ORS PTIC?
S ter( s
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. 6ans or additional information may be required to be submitted, and subsequently approved before
this application can 4e'jrocessed i
Signature
Date _AA ye) (,
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash 0 Check 0 Mastercard 0 VISA 0 Other
Bankcard #: Expires: - VIN#:
Authorized Signature:
REVISED a25/2005