2015, 03-12 Permit: BLD-2015-0485 ResidenceSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-2540
Fax: (509) 688-0037
permitcenter@sookanevalley.orq
3( -D, -Doi -6f
(Staff Use 011410
PERMIT NUMBER:
PERMIT FEE:
CSV PERMIT CENTER
T REV. # r----1
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION ❑ ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ DECK ❑ OTHER
SITE ADDRESS: //512 t• �`(,dcrcas4 'Or -
ASSESSORS PARCEL NO.: /no 003 LEGAL DESCRIPTION: /6,4 7 y(l< l (y,,//, ,7?ac(
BUILDING OWNER NAME:
NAME: 4 et f COnc34114. o•)
ADDRESS: /MS0 14,1,P�l�f�K
CITY: 6C4' /17:7-tcna
L #707
PHONE: aoy. 7]). 3000
CONTACT NAME: Lo; SoycItr
PHONE: a RC) 2, 7)7. 3p0o
FAX:
STATE: -rjQ ZIP: 83/ty
CELL: lS• 334- 29Z2
FAX: CELL: 6(0-- 3 - 2p2z
CONTRACTOR NAME: /tler¢ C64Ori,c4c,
MAILING ADDRESS: /Q6 -o A Of/ -07
CIrY: lroc../r-
STATE:
PHONE: do i. 77 7, °3000
CONTRACTOR LICENSE No.: rCL:
DESCRIBE THE SCOPE OF
I nyc 4 n/: (y s %ii-. c
FAX:
2517 `! D EXPIRES: CITY BUSINESS LICENSE NO.: Mn (t SCC l277
WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
Nc,w ('.o68ifucf1,1
CELL:
ZIP: ;32/y
C' 5 - Z/Z2
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
�`
Dimensions:,No.
30xsy
of Stories:
,a
Total Habitable
Space: o?/67
Main Floor SQ FT: a
030
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT: $321
Garage SQ FT:
g p e
Deck/Covered Patio SQ
FT: Hy is
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type: IV -0
Heat Source: Gj4, -Le44( ,
Sewer or Septic: P Sc�r-
TOTAL COST OF PROJECT: $ 130,00v
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.
Signature
Date:
Updated 1-11-11
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