2013, 06-12 Permit App: BLD-2013-1090 ReroofSpokane
Valley
Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Spokane Valley, WA 99206
Tel: (509) 688-0036 PERMIT FEE:
Fax: (509) 688-0037
permitcenter@si okanevallev.orq
Project = 8(d 3— o O
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION ❑ ADDITION/REMODEL D ACCESSORY BUILDING
0 DECK 'a -OTHER
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SITE ADDRESS: `�jI l giv'tx i`i�� �- 'J IfV1� 1TEf "�
'� i Al
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: -R/cf T T —
NAME: 3y
ADDRESS: • ZS � 14%06"
CITY:
PHONE:
CONTACT NAME:
FAX:
STATE:
lS h ZIP:
CELL:
PHONE: 5 % IQ 9 - a ,,z FAX: IV/ CELL:
CONTRACTOR NAME: rA f JA1 7-6'iZ /Ocure rT
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
D C IBE TfrIE SCOPEre_;ORKIIN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
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:
Constructigh Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $
X0000 o
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 re ed to be subrpitted and subsequently approved before this application can be processed.
Signature
,Vp6
Date:
/2-/3
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_ _Residential_11-11-11.doc