2014, 05-19 Permit App: BLD-2014-1099 Residence Community Development Department (Staff Only)
Permit Center
�" :1703 East Sprague Avenue,Suite B-3e[fY :7,,,,,‘,:-,''-'=-,,,.,,,,,,,,_,
� `s Spokane Valley,WA 99206
Tel: (509)7200-2540 Pee::
Fax: (509)688-0037
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RESIDENTIAL CONSTRUCTION IERMIT APPLICATION V.
NEW CONSTRUCTION RUC ION ADDITION/REMODEL I ACCESSOR BUILD G
BECK 0 OThER 1 PERMIT ENTER
S E ADDRESS: 17 e'0 ( - ,
c - -- 3-e ct _
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: 7 'Aj IT /k .3
BUILDING OWNER NAME: ijk,a ci, 1,,i 0,1 s• :\ r,
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NAME: ..i ,1s-VyLr i1 _ iidG. -
ADDRESS: - 0 . t c(t 3.
{ 114111
Cm: Sri 1464.4 II -e ��STATE: ZIP:
CONTACT NAME lJ('it�.1 jrt UA14f1/t 34r
-PHONE: ID'/. /2? 71Y ? FAX: -5"DG,t 2- r--'��v4 6 .a.: 67r--6i - 'F Jr'_, .5--i
CONTRACTOR NAME: Ki.taikaiam( - . E,,F
mAnarts : f3 660,4 i I"t 3()
i' f STATE: / ZIP: 4192/4(
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PHONE: (15'2.."4 1 47 2.721 " / ' 7 Xr(F-.v'j) V -f(f : 402-r f- Ts7(
CONTRACTOR LICENSE NO.1,i 4{4 K l4 41 c 4/J K EXPIRES: 3//.3/A54 ITY BUSINESS LICENSE HO.: 7-e zed' '-.GtGG 4/5i:
DESCRIBE ME SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPETE THE FO LOWING****
MARKIN_A IF ..,, :i SLE
Heigtit tolze8 Dimensions: Ns.of Stades Total Habita, .
Main Floor SQ FT.. �--- Upper Floo .FT: Unfinished B $Q Finished Basement SQ 1
FT: Fr :
Garage SQ FT: Deck/Covered Patio SQ Impervious r 30%Slopes on
y3 0 FT: C; Ate: /(f� 0
No. of Bedrooms: Construction Type: 010-19 Heat Source: 3e1_,.‘
or Septi 1
TOTAL COST OF PROJECT: $ 0
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DISCLAIMER
The permed verfes,acknowledges and agrees by Mar- signatures that: 1)if this permit is for construction or on a dwelling,the dwelling is/will
be served by potable water. 2)Ownership of. is City of Spokane Valley permit inure to the property owner.3) The signatory is the property
owner or has permission to represent the owner in this transaction. 4) Ali construction is to be done in full compliance with the City of
Spokane Valley Development ood . -j= • • codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a it or .. . -1 for any violation of federal, state or local laws,codes or ordinances. 6) Plans or additional
information may berired t be m' - .• subsequently approved before this application can be processed.
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Signature l at
Pace l of i
Updated 1-11-i1
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t4)://w .spokenevalley.orglfi4estorage/124/938810/94-8/1496/2743/Res_Perrnit.dac