2012, 07-23 Permit App: BLD-2012-1170 Residence• ai Community Development Department 40
me. Permit Center
11703 East Sprague Avenue, Suitel3-3 PERMIT NUMBER:
Spokane Valley, WA 99206
Tel: (509) 688-0036 PERMIT FEE:
Fax: (509) 688-0037
permitcenteresookanevalley.orq
(Staff Use Only)
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
i( NEW CONSTRUCTION ADDITION/REMOD14.11 itedEBUIEDINGI
a DECK II OTHER Pr harLLE, -La&
SITE ADDRESS: 57124 1-1412-/e4d EiE)
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
111
BUILDING OWNER NAME:
NAme: i,A1 4. 110.01.< LLL.
A.REss: izto Al viJeasir-f FP 41--,9C2
cn-y: Z-7ffoie.14/4- (AY,/ Fy
STATE:
CONTACT NAME: ktOthaj /4.4ajtj
P.4°Ng: 2/2—G0000FAX: 91/2e2/
CONTRACTOR NAME: L
711-0,40.<
CELL:
ZIP:
V.7*tor742;)
NAILING ADDRESS:
CELL:
PHONE:
6,--7425)
CONTRACTOR LICENSE No.:
DESCRIBE THE SCOP OF WORK IN DETAIL AND,INDICATE USE & PROPOSED USE:
A..) /WI D.-0,,vfr/Ak„ (.OLJA4-AredLri7at)
PAX:
cam: Z17— 4;710
D
EXPIRES:
CITT BUSINESS LICENSE NJ
****YO(J MUST COMPLETE THE FOLLOWING****
Upper Floor SQ
Unfinished filisginirtity
PT:
Deck/Covered Pati•kr Impervious Surface
FT: Ares:
TOTAL COST OF PROJECT: $
/75, no 0
Total Habitable A
ce:
Finished Basement SQ
FT:
304% Slopes on
ProroeTtT:
PIAGLAUSR
The permitted verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction or on a dwelling, the dwelling is/
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the prom
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the Or
Spoicane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The Cit)
Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additic
information may be required to be submitted and subsequently approved before this application can be processed.
Effective October 28, 2007Page 1 of
PAComrnunity Developrnent\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Perrn
ADD 10.28.07.doc
SPOKANE COUNTY BUILDING AND PLANNING
PERMIT
Application Number: SW -12001542
Permit Issued Date:
06/13/2012
Expiration Date:
Project Description:
Project Name:
Permit Type:
SEWER CONNECTION
ROTH ADDITION
SEWER
Primary Contact: FOLSOM EXCAVATING
Applicant: FOLSOM EXCAVATING
Address: 16701 E VALLEYWAY
VERADALE, WA 99037
Phone: (509)979-6002
Email:
SITE INFORMATION:
Site Address:
Parcel Number:
Subdivision:
Assessor's Description:
Inspection Area:
Zoning:
5104 N MAYHEW RD
46344.1705
PLAT NO 4 OF WEST
FARMS IRRIGATED
TRACTS
ROTH ADDITION, PHASE 1: LOT 5 BLK 2 (AFN
6055341 - PTN SE1/4 OF 34-26-44)
Owner:
Address:
Phone:
Email:
LOTS N LAND
210 N UNIVERSITY RD STE 300
SPOKANE VALLEY, WA 99206
Water District: Trentwood Fire District: Spokane Valley Fire
Irrigation District #3
Land Area: 0.1826 acres / 7954 sqft
CONTRACTOR INFORMATION:
General Contractor
FOLSOE1994D0
FOLSOM EXCAVATING INC
16701 E VALLEYWAY AVE
VERADALE, WA 99037
509-891-1232
ro__•
DETAILS:
Class
Type
Quantity Unit Charge Value
SEWER SEWER CONNECTION
FEE DETAIL:
Processing - Utilities
Utilities Permit
1 $125.00 $125.00
Total Fee:
$125.00
$25.94
$125.00
$150.94
CONDITIONS:
FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO COVER.
ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL INSPECTION FEES
APPLY AFTER 30 MINUTES.
Date Printed: 06/13/2012 08:12:10 Printed by: IIS APPPOOLASP.NET v4.0
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