2008, 08-14 Permit App: 08003163 Remodele
~'p Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 1063ED BY
Spokane Valley, WA 99206 VALLEY
(509)688-0036 FAX: (509)688 -6th
www.s okanevalle .orastat +;
Residential Construction
Permit Application
SITE ADDRESS
ASSESSORS PARCEL NO:
❑ Ne Construction
ddition/Remodel
❑ Other:
o Accessory Bldg
❑ Deck
o1Oo3
Buildin
Name:
Address:
City:
Phone:
owner
Fax:
Zip:
LEGAL DESCRIPTION: L
Describe the scope of work in detail:
**************The followin
HEIGHT TOP • K:
Iu
MAIN FLOOR TO SQ.
FTG:
FINISHED BASE
SQ. FTG:
# OF BEDROOMS:
Contractor
Name: t~ SCI
Address: e
City: J
Phone:
Lic No:
City Business Lic No:
Cost of Project:
Exp. Date:
MUST be com
DIMENSION :
FLOOR SQ. FTG:
NT
GARAGE SQ. FTG:
&
lete:
CONSTRUCTION TYPE: Y
write N/A if not a
licable
# OF STORIES:
UNFIN BASEMENT SQ. FTG:
DECK/COV. PATIO SQ. FTG:
HEAT SOURCE:
C 1
**********************
TOTAL ABITABLE SPACE:
IMPERVIOUS SURFACE
AREA:
30% SLOPE ON
PROPERTY: /v
SEWSe-t)- OR SEPT C?
DISCLAIMER
The linbeifie acknowledgesby potable water. 2) es by their Ownership of this rCity of Spokane Valley Permit inure construction
to the property owner.ng, the
3) The
dwellingais/willisth be served w e aowner in this transaction. 4) All construction is to be done
signatory is the property owner or has permission to represent the property
full
Valley the Citye of Spokane Ci Valley of Spokane Valley Permits not a permeferenced it or approval available for review at the City of violation of federal, state or
Spokane Valley Permit Center. 5) T approved before
local laws, codes or ordinances. 6 Plans r additional information may be required to be submitted, and subsequently
this application -n b p s'e.se
Signature
Method of Payment;
0 Cash
Bankcard #:
Authorized Signature:
REVISED 5252005
ed permit ap
0 Check
.z.5)
Date _1:43393----_
339
ations will only be accepted with major ba )
VISA
❑ Mastercard 0 VIN#:
Expires:
0 Other