2006, 09-29 Permit App: 06003908 SidingPermit Center
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pokane 11707 E Sprague Ave, Suite 106
conspo
Valle Y Spokane Valley, \VA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www spokanevallev org
Residential Construction
Permit Application
SITE ADDRESS
ASSESSORS PARCEL NO:
PERMIT NUMBER: mo
PERMIT FEE: ae S
New Construction n Accessory Bldg
E Addition/Remodel n Deck
IN Other: %i*r4on f 7
V l wy
LEGAL DESCRIPTION:
Building Owner: _
Contractor:
Name.
Daw-id + ShR-; la l4-a-rr t` son
Name:
K-
Address: G2,/7
City. Koo
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,5" ` z(Z4-ti, 5...}
77 . State: Uv4_
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Address: 1{7o3 Ar Luc- /it
City. S(po .. State: pjp Zip: f 92/
Phone: 5-0, - !02`7 ' 5-133 II Fax:
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Phone: tloo— y29-9 4'3 Fax:
DECK/COV. P, TIO SQ. FTG:
W A
Contractor LjcDNAs i 4(053 Og.xp Date: e/ _ / , of
0
Contact PersolIn�
CONSTRUCTION TYPE:
res ding
City Business Lie. No:
/'
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Name: Fet.A.- _ (cook
[
Phone: I- ice -511 -'t3-q 3
Describe the scope of work in detail:
Cost of Project: S'11071 9 7
**************The following b1UST be complete: (write N/A if not ap)licable)**********************
HEIGHT TO PEAK:
DIMENSIONS: -
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2n" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. P, TIO SQ. FTG:
W A
30% SLOPES ON
#
PROPERTY: M/i'
OF BEDROOMS:
CONSTRUCTION TYPE:
res ding
HEAT SOU CE• N1
SEWER O .SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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, and subsequently approved before
this application can be processed.
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 825(2005
XCheck
❑ Mastercard
Expires:
Date
❑ VISA
VIN#:
•
trio.1/2430 S1C EFt5
HOME itLMODIMINC%IF AIDER
Fax Cover Sheet
To:
Fax:
Uhl.)- T -4-5- Lo 4 b`5
8647 South 212th Street Kent WA 98031
Ph# 253.872-3440.800-528.9543•Fa d! 800-778-6785
From: joCII
Pages:
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