2013, 04-18 Permit App: BLD-2013-0677 Residence•
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.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION rs ADDITION/REMODEL
. DECK .2 OTHER
E3 ACCESSORY BUILDING
SITE ADDRESS: `��� tf LLY'R-
ASSESSORS PARCEL NO.:,71-635/v' 35/v' / j6'.6 �J LEGAL DESCRIPTION: LOT .' /0T 6
0,6_
BUILDING OWNER NAME:
NAME: (/ j
ADDRESS: � (� Vfift(kia5rNi
CITY: KoAti Nt' STATE: ic A
PHONE: FAX: �ZZ 0/9c -
CONTACT
` / J
CONTACT NAME: DA/NI l� c L /Jt
CELL:
ZIp: .9126:.
PHONE: � 79 FAX: ( O`' CELL: 79
CONTRACTOR NAME: botO frte6 G
MAILING ADDRESS: ' O V r JE 're4f0c,
CELL:
CONTRACTOR LICENSE No.: L Qom,/4,g, EXPIRES: /-t?-/Z/ '/L/ CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
e -
Si A
i� J Gam( O
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: /6
Dimensions:
)
No. of Stories:
!
Total Habitable L„ d f {�
Space: /Z-• ftr
Main Floor SQFi in
II-�—'-�
Upper Floor SQ FT:
Unfinished Basement SQ
FT: -'.----"
Finished Basement S
FT:
Garage SQ FT: h4
dar..)
Deck/Covered Patio SQ
FT: /.) -1
!
Impervious Surface
Area: .__.----�
Heat Source: t1
30% Slopes on
Property:
Sewer r Septic:
No. of Bedrooms: ,
. -pe J irj j
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 b required to be,-Subr fitted and subsequently approved before this application can be processed.
z /./ /3
Eff a October 28, 2007., Page 1 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Pe it Center\Residential Construction Permit
App 10.28.07.doc
•
[41'
FV4f ).Dpr1c-21,1
1%''J )100,F7
444-144.1*
flc
to*44•441F-?
f/ -U/0(77
‘,1;0621
C-fhfi-)
poP
a21,14-. PP)Iq
'1.6). oo
&4.
ojte
N'4P?!