2014, 05-29 Permit App: BLD-2014-1227 Residence#1,`"
SijOkane
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-2540
Fax: (509) 688-0037
permitcenter@spokanevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLi ATIoN ER
NEW CONSTRUCTION ❑ ADDITION/REMODEL
DECK ❑ OTHER
SITE ADDRESS: ('7 /Z 11/ "=e -e r
acL
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: (',,) v'r.-
NAME:
ADDRESS:
/ 9-2 6 n/ fes.--ee a 6 r? 5 /204
Cm:
PHONE:
5 0 k c— Le V ire
57)2 4199_ -2792-
CONTACT NAME: j GG -t/1 e_
PHONE:
C57
STATE:
2792-
STATE:
1,1Q
zip: 95'6 / !�
FAX:
gZ 9 k 7 / 5'7/ 5- CELL:
FAX: cELL:
CONTRACTOR NAME: `f �27io-if�y�
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
I31,i id w S; It : /y Res,
Height to Peak:
Main Floor SQ FT:
111�•�-
Garage SQ FT:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N A IF NOT APPLICABLE
No. of Stories: Total Habitable
/ Space: / .5147 -2 -
Upper Floor SQ : Unfinished Basement SQ Finished Basemgpt SQ
FT: f
Dimensions:
?2,.)/3c D
FT: e5 -
No. of Bedrooms: 2
Impervious
Impervious Surface 30% Slopes on
Property: (
Deck/Covered Patio SQ
FT: 3 $U
Construction Type: cra�- Heat Source: &led -
TOTAL COST OF PROJECT: $
�/. )(y
Area: / 2 4i 2
Sewer or Septic: 5e
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The 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
Date:
qp/e/
Updated 1-11-11
http://www. spokanevalley.org/filestorage/ 124/938/210/948/ 1496/2743/Res_Permit.doc
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