2015, 05-18 Permit App: BLD-2015-1141 Addition, ReroofSC�liit
jValley°
RESIDENTIAL
D NEW CONSTRUCTION
DECK
SITE ADDRESS:
Projec
Community Development Department
Permit Center
11707 East Sprague Avenue, Suite 108
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
perm i tce me r(al spoka n eva l l ev.0 rq
PERMIT CENTER
SUB #
CONSTRUCTION PERMF
El/ADDITION/REMODEL
OTHER
ACCESSORY BUILDING
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK Box, IF MAIN CONTACT El):
NAME:
C -caw(.. CL, \ . 1) • ---)t1w.C\- A
ADDRESS: V9 ZS N..) \—\\.C:1\
.1,—,(LYX10 ., 1 ` , r�
CITY: .O \ `�esto E V CIO.— I-- E -( STATE: G� -
59±1359±13ZIP: CkCk(4t (i
PHONE: — a --+c,_,,,,-.3 OO) I FAX: EMAIL:
CONTACT NAME:
PHONE: FAX:
EMAIL:
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT ❑):
MAILING ADDRESS:
CIrv:
STATE:
ZIP:
PHONE:
FAX:
EMAIL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE COPE OF Ff WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
/G' F�- i�d.�:��or� c 4o esn elk t& yes:4e..
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABL_E
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
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,
•a
Signature rt G L t. Date: .5—\8- \5
S ECEAP ADMIN
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05/20/2015
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