2014, 08-05 Permit App: BLD-2014-1868 Remodel Project
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B 3 PERMIT Ny� Rt 5 2014
HUu U
poliQ�l�l i,e Spokane Valley, WA 99206
Tel: (509) 720-2540 j PERMIT FEE:
Val ler
Fax: itcen 688 0037
4000
pax: (5 9) 688-00 anevallev.org GSV pC(1MiT CENTER
SUB # REV. # �
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION D ADDITION/REMODEL ACCESSORY BUILDING
DECK OTHER
SITE ADDRESS: /03* Stra •/ �,4 ,f Va/C y Alt 992.E
ASSESSORS PARCEL NO.: / , LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: ) .SpHcr'jC�
ADDRESS: //x2/ro fl �eplN
CITY: J�GC w STATE: 4}4_ ZIP: 9I9
9/
PHONE: Sof 50-/Ill FAX: CELL:
CONTACT NAME: ...6th ov g1,'/Gr
PHONE: FAX: CELL:
CONTRACTOR NAME: ! Qfs,(oc ( ',Jt''4c//sti
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
F.-am-10 / - s, r /IF(( n ' V- , �14� // L,
eti S S 5e6L/ (/xj %/l/ S£C/rns ( ,Sots P 3 /f,
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No. of Stories: Total Habitable
/0 Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
FT: FT:
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30% Slopes on
FT: Area: Property:
No. of Bedrooms: Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ (StOCO
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: ? /26N
Updated 1-11-11 Page 1 of 1
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