2006, 05-19 Permit App: 06001911 SidingSoakane
,SValley
Community Development
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokaneval levo re
Residential Construction
Permit Application
SITE ADDRESS 1) ? k--,�1r12Q
ASSESSORS PARCEL NO:
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PERMIT FEE: 3 617.13
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❑ New Construction
Addition/Remodel
ther:
LEGAL DESCRIPTION:
ier
Name: i 1-)fiRy MY' IQTi‘ IW 5
Address: I J� q
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City: s ipp Ks we
State: (4),.:) Zip: 9ccG /6
Phone q_ 92.7 ` �4 5- / Fax:
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Name:
Phone:
❑ Accessory Bldg
❑ Deck
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Name:RO,Jexr %4, iii)//a))05
Address: iP 0 gax $ a 5 -
State: /,/,1
Fax:
City: --7-4.c pr n
Phones 3_ 2, % —� cp.--
Contactor
pContractor Lic No: i) ai}T/9c 9 `tOk a ate:
City Business Lic. No: •
Zip: ,f5 y jr
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Cost of Project: $`2-)
Describe . scope of work in detail:
. **********************
111C IMMO
HEIGHT TO PEAK:
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DIMENSIONS::
IVX2C
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# OF STORIES:.
i /2
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 can be processed.
Signature 6),..A4,3,5,
'
Method of Payment:
0 Cash Ereheck
Bankcard #:
Authorized Signature:
REVISED 8/25/2D05
Date 5-- / % d 6
❑ Mastercard 0 VISA
Expires: VIN#: