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2015, 03-12 Permit App: BLD-2015-0484 Residence
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@spokanevallev.orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: RESIDENTIAL CONSTRUCTION PERMIT APPLICATION ® NEW CONSTRUCTION ❑ DECK ❑ ADDITION/REMODEL ❑ ACCESSORY BUILDING ❑ OTHER SITE ADDRESS: Hsu, C . ✓c<<icsf 10r - ASSESSORS PARCEL NO.: 4504.1'3 -OP, BUILDING OWNER NAME: LEGAL DESCRIPTION:/,/ $ ,3/,' / Gric Ax -/e NAME: /1Of4 6,4 4,44,4.11;00 ADDRESS: /4,3 Id `3e((GcivL Ln 41 /e7 CITY: COttr 4f)/c,. STATE: -TO ZIP: F3 r PHONE: .20$.727'• 3000// FAX: CELL: toes'- 336-a ?ZZ CONTACT NAME: Ltv , Sny ettr PHONE: G /S- 3`36- 270Z / FAX: CELL: 6(6-- 33i� Z DtZZ CONTRACTOR NAME: /'%c/ 6,04r,e/,'„ MAILING ADDRESS: /132 W "BL((crt'oC (o 14 j(N7 CITY: ("Cu r STATE: -7#2 ZIP: ?3 fig PHONE: 09 717• 3600 FAX: CELL: G t s'- 336- 2..tz CONTRACTOR LICENSE No.: PLA --4=2/ 71-fo EXPIRES: CITY BUSINESS LICENSE NO.: PIC)P`TC/2/7C7 DESCRIBE THE SCOPE O WORK IN DETAIL AND INDICATE USE & PROPOSED USE: 5 in ,$ lin.'/y ft .c,7tc A/e..r 42,7J-fivc/i'o 1 ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: . , Dimensions: 3 ix cid.' No. of Stories: Total Habitable Space: .71' Main Floor SQ Fr:/, Upper Floor SQ FT: IK Unfinished Basement SQ FT: Finished Basement SQ FT: Garage SQ FT: 4D10 Deck/Covered Patio SQ FT: Impervious Surface Area: 30% Slopes on Property: No. of Bedrooms: 3 Construction Type: ILO Heat Source:ats fjr,i L. Sewer or Septic:,s. r TOTAL COST OF PROJECT: $ /5°, Uv° DISCLAIMER The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a 9'v H9r(o~tE t 1 s, wig 4 be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the properly owner. 3) The si na o i e dRfert �� owner or has permission to represent the property owner in this transaction. 4) All construction is td 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 Perrriyeitgr )Z City of Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, c©des or ordinanc 4� Pans tell ditional information may be required to be submitted and subsequently approved before this application can be processed. Project #._8(_D - DISCLAIMER _D Signature 5 CSV PERMIT CENTER Date: �u� j REV. #1 Updated 1-11-11 C:\Users\levi\Desktop\Permit Folders\Spokane Valley Permit FOR USE\Res_Permit (1).doc Page 1 of 1