2012, 06-25 Permit App: BLD-2012-0962 Additioncogvalley
Community Development
Residential Construction
Permit Application
11703 E v y gue Ave, Suite B-3
Spokane y, WA 99206
(509)688- 36 FAX: (509)688-0037
www. spokanevallev.org
•
PERMIT NUMBER:
PERMIT FEE:
❑ New Construction ❑ Accessory Bldg
® Addition/Remodel ❑ Deck
❑ Other:
SITE ADDRESS: /OZ 0 Z r /tk )55/OAJ MVL
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building Owner:
Confractor: '
Name: //A nig/0 C c 4.D 17
Name: lag IG// i .
901277 Cres S0it5P-Cc.av LL L
Addresst:� /OZO z /E pyi IS9"0A/ All
Address:/5700 iE Cqpide1 g AUL
city: 5pewit M%i yaws? State: Log_ Zip: f'3i
Phone: 917— gem/ Fax: 9Z7 r399Z
State: A- Zip:y , 24k
CitY 5(44)17 VA <uwg W
9 2, -to 5oO 4/60 Fax:
FINISHED BASEMENT
SQ. FTG:
ContracW Lii N�V.5S 99Z fS fT Exp Date`g /_/ // -
Contact Person
30% SLOPES ON
PROPERTY:
City Business Lie. No:
CONSTRUCTION TYPE:
HEAT SOURCE:
• A/'ol/g
SEWER OR SEPTIC?
5eSwM2
Name: '0a' („ J (L/ &A1T
Phone: 9 2.7.--// qD
Describe the scope of work in detail:
Cost of Project: $ v
Co menu ecir A /ccA'leo ! _5)4- tC/Si_ PaazHt bc-/Leev+pope,/ Coil ,
Proposed Use:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TQ PEAK:
/O
DIMENSIONS:
/O Vs/,6
# OF STORIES:
/
TOTAL HABITABLE SPACE:
/6o e=ra
MAIN FLOOR TO SQ.
FTG: /loo rr�
2NO FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:
No alit
CONSTRUCTION TYPE:
HEAT SOURCE:
• A/'ol/g
SEWER OR SEPTIC?
5eSwM2
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 2115/07
0 Check
❑ Mastercard
Expires:
DATE: j /2
0 VISA
VIN#:
/act 13IO-t0IZ-0&z_
RECEIVED
JUN 2 5 2012
CSV PERMIT CENTER
SUB # REV. #
-PA,
16
Project #2012- ?-atiol,
RECEIVED
JUN 2 5 2012
CSV PERMIT CENTER
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