2014, 09-17 Permit App: BLD-2014-2167 ResidenceSame
#ValleyA
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 6-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter(°lspokaneva I lev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
IProject #
Pr rnfr-
RESIDENTIAL CONSTRUCTION PERMIT APPLICATIOND.
i
® NEW CONSTRUCTION ® ADDITION/REMODEL E ACCESS.ORYLBU_ILDING
0 DECK ® OTHER r
SITE ADDRESS: /'8 ' 6 C 014,'-5, ^ AS,Y4 ERMiT CENTER
ASSESSORS PARCEL NO.: /j/So`I / , 3G 3 5` LEGAL DESCR;IP_TION: S-jS? 3_ U. er••-
BUILDING OWNER NAME: 6UC. (-(e-- /44 ���Zert `J I —J
NAME: J l) !/( P C✓ /21,,_ C
ADDRESS: / /G / 3 }6-,
CITY: G kel C_
PHONE: SCF 7's/ c,23? //
CONTACT NAME: �// l (05
STATE:
FAX:
/4Pc)
z4
SC -r7
C %✓mac
CELL: LamC-r ?57 O73S
PHONE: FAX:
CONTRACTOR NAME: - —k-' 2 _ ?._ • (,ol>> Z l C
MAILING ADDRESS: 2 ?(0 E : 3 1-1--
CELLLL@? 9O-/ 073 /•
CITY: krf -c
STATE: Cd-' 4-
PHONE:
FAX:
ZZIP: 7>O2
CELL: S—rS:9st" #23 (
CONTRACTOR LICENSE No.: - EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
N/A IF NOT APPLICABLE
Height to,PPeak:
Dimensions:
No. of Stories:
Total Habitable
Space: lyp6
Main Flgor SQ ET:
('cl�G
Upper Floor SQ FT:
Unfinished Basement SQ
FT: fd
Finished Basement SQ
FT: fir -
Garage SQ FT:
Co?p
Deck/Covered Patio SQ
Impervious Surface
Area:
300/0 Slopes on
Property:
FT:-
No. of Bedrooms:
Construction Type: r (4
Heat Source: C4-5 -3
Sewer or Septics' s c—
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 Deveiopmen(((((( code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not mii or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required 1 uti fitted and subsequently approved before this application can be processed.
Signature
Date: j/o //
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