2013, 01-22 Permit App: BLD-2013-0089 Residencee
•
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenterftsi okanevalley.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Ni NEW CONSTRUCTION ❑ ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ DECK 0 OTHER
SITE ADDRESS: 1 ' 3G Pt --
ASSESSORS PARCEL NO.: L-4S0L-V-A j 7 3 z LEGAL DESCRIPTION: Let 32VAcc-ki in tie
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BUILDING OWNER NAME:
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NAME:/" IG%t-:" k CGC-) 5-k5t lC-.. . (on // c7 1LC : no-) k 0 e s
ADDRESS: 1 I S 0 FC' v\ t 51 • & ! _G G1 e LA t k E ( --
CITY: Co. e N is c /,q \ en e STATE: i6 ZIP: j ZS i y
PHONE: --7-/--,,g 777 �C FAX: CELL: Ze 2. 66-0. 001-2-)
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CONTACT NAME: 15-e „^v) y �. G C \ S
PHONE:
FAX:
CELL: ZC�'(R. cty .
CONTRACTOR NAME:
MAILING ADDRESS: c-1-‘'Ct
Cm:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.: M of,— 1KCC ?C 7 EXPIRES: 3 1(21/ y
CITY BUSINESS LICENSE NO.: 6-001 y(0 1030
DESCRIBE THE SCOPE OF WORK IN DETAIL AND IND CATE USE & PROPOSED USE:
/le..0 co u tc-k + a :Th t a, � e -� U on t t �� e7 h k V\
cx qc:\ e �;a zs--cx
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: /
Zt-A
TOTAL
Dimensions: /
Z`: , 4-kO
No. of Stories:Total
Z
Habitable
Space: 176,6, Er
Main Floor SQ FT:
1101-k
Upper Floor SQ FT:
Unfinished Basement SQ
FT: 66v -Z-
Finished Basement SQ
FT:
Garage SQ FT:
s Z-(8Z-(8FT:
Deck/Covered Patio SQ
G%�
Impervious Surface
Area: ^^ ,
v
30% Slopes on w +‘-‘"+,n
Property:
eeo�-k-
CaS�
No. of Bedrooms: Z
Construction ype: V13
Heat Source: (; �A
Sewer or Septic: Se ,e,-,--
,,ems
TOTAL COST OF PROJECT: $ 97000
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.
Ef ective 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
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