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2013, 02-04 Permit App: BLD-2013-0169 RemodelSpokane Valley Community Development Department (term it Center 1703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 perm itcenterPspoka neva I lev. orq Project ,; RESIDENTIAL CONSTRUCTION PERMIT APPLICATION Q', NEW CONSTRUCTION 0 ADDITION/REMODEL D DECK 0 OTHER SITE ADDRESS: /6/y 5 L;41ef;6.1� Zr- ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:" BUILDING OWNER NAME:' ACCESSORY BUILDING SV pr_-r.`'1!T CENTER NAME: ADDRESS: l'=b/`7 CITY: 5(20 .0 �%d l � STATE: kr/t- FAX: PHONE: 3g $ - 23— CONTACT NAME: ZIP: 70 CELL: PHONE: FAX: CELL: CONTRACTOR NAME: MAILING ADDRESS: /,7/ CITY: )5 PHONE: 25 4-/---0..D(9 2 e FAX: STATE: !�/r- ZIP:. 5/ 0' 2 '-- CELL: CONTRACTOR LICENSE No.: 1A0/4/*-LEXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE: #c Frith.."4 fYR") 7)04 s kez. , rot % .0`, I (O n1, ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: Dimensions: No. of Stories: Total Habitable�Z Space: /, 00 i 7 - Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ FT: Finished Basement SQ FT: ca c_30 01-7- Garage SQ FT: Deck/Covered Patio SQ FT: Impervious Surface Area: 30% Slopes on Property: No. of Bedrooms: Construction Type: Heat Source: Fv,.,i , -'-' Sewer or Septic: ,,,,,,,-- TOTAL COST OF PROJECT: $ / 3 ©00 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 repret the property owner in thi ransaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development co00. Referenced codes ar- .- ailab - for review at the City of Spokane Valley Permit Center. 5) The City of Spokane Valley permit is not a permit or approval for a v .la of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted and subs- . - ..yved before this application can be processed. Signature J/, L Date: -2//( 3 Updat 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_ _Residential_11-11-11.doc It ley 7. Project # &G&-?�.�&f 1 HEC IE FEi042013 CSV PERMIT CENTER SUB # / 1 REV. #