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2013, 06-28 Permit App: BLD-2013-1263 Residence
Spokane Valley • Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenter©spokanevallev.org (Staff Use Only) PERMIT NUMBER: PERMIT FEE: RESIDENTIAL CONSTRUCTION PERMIT APPLICATION NEW CONSTRUCTION ❑ ADDITION/REMODEL ❑ ACCESSORY BUILDING ❑ DECK ❑ OTHER SITE ADDRESS: ASSESSORS PARCEL NO.: 5c. ISI . 133 LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: ADDRESS: CITY: STATE: ZIP: PHONE: FAX: CELL: CONTACT NAME: (3-AcSv PHONE: g4 -D -19b3 FAX: 32$- I 9 CELL: 951- 19 b3 CONTRACTOR NAME: �j'r12A.1-\-L_ CioAt t, -00,\I, / 1\l C MAILING ADDRESS: 2v 1 I nl CA -L1 Ste( S\ CITY: ,i c:A<A 4\1 STATE: WA ZIPP: 7 / 2A3S ( PHONE: IS) - 19 O 'j FAX: 3z5 -1-9 I l CELL: 9 / -/p / b CONTRACTOR LICENSE No.: c3rY -I-I' `LI_c �,/) i_ N EXPIRES: 'I � � / 1 1-J CITY BUSINESS LICENSE NO.: % 'i4-C,R_?(P9 L(� DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE: C 4sr eT7oi 4 .0 Al E -R) iIt' (_L E rFAH1i( L 1 t rutE- ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: (r Dimensions: 4'] X ;,:-?) No. of Stories:Total I Habitable Space: Main Floor SQ FT: '11 ,' Upper Floor SQ FT: p'" Unfinished Basement SQ FT: q I 2 Finished Basement SQ FT: Garage SQ FT: IY I q o 1 Deck/Covered Patio SQ FT: __4 Impervious Surface Area: -- 30% Slopes on Property: No. of Bedrooms: Construction Type: Heat Source: Sewer or Septic: TOTAL COST OF PROJECT: $ 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 and subsequently approved before this application can be processed. Effective October 28, 2007 Page 1 of 2 P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doc ,sztj-tuAs StAA_R 2S, • • VAvece—L. 55►g1. ��3g, N D 2 2 Lo -T DATE: cot - z-►' I.STII\LG 32 1-5 1`\ \SS\ D N AV 0E_ w 7