2014, 07-14 Permit App: BLD-2014-1673 Pre-inspection Fire DamageSclTyoe'I' _e
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(a spokanevalley.orq
PERMIT
NUMBER:
(Staff Use Only)
PERMIT
FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW
CONSTRUCTION
BUILDING
DECK
ADDITION/ REMODEL ACCESSORY
SITE ADDRESS: 1303. 7v LA 'N-1
ASSESSORS PARCEL NO.:3CI31 • O74,1.
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: Yt„ A P KT' (6 1,'f G)
ADDRESS: 130.3 N• G(L
CITY: 6k-Ax,e L,)y4u..0
PHONE: S-61. 3.147, 9 FAX:
CONTACT NAME:
STATE:
w.A
CELL:
ZIP: L
PHONE:
FAX: CELL:
CONTRACTOR NAME: C2+' P14'✓5 CQ•u3!'x-l.Gyl�l�sv�
MAILING ADDRESS:
CITY:
')_A a-(4 ti.• 1i&VAA4
S ¢G�.ao x.eti
PHONE:
S3°tr s3Z • 66 S-4"."
CONTRACTOR LICENSE No.:
FAX:
STATE: I 44 ZIP: 59,U)1
CELL:
5ZO.S"Th.gy77
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
'FM& A. 4e eter}tpyl 64/1-4,tle Axil) 8R -66Z 'All
****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:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ 9()/ e v.4)
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 dPlt1 sujlsequently approved before this application can be processed.
Signature
Revised 1/192011
Date: `'
http //www. spokanevalley.org/filestorage/124/938/210/948/1496/2743/Res_Permit.doc 7/14/14, 12:13 PM
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