2013, 11-14 Permit App: BLD-2013-2368 Egress Window Community Development Department (Staff Use Only)
;a Permit Center
: 11703 East Sprague Avenue, Suite 8-3 PERMIT NUMBER:
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Spokane Valley, WA 99206
Tel: (509) 720-2540 PERMIT FEE:
valley Fax: (509) 688-0037
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ DECK ❑ OTHER
SITE ADDRESS: /2 6 x 1 E sk v 1 ems,
ASSESSORS PARCEL NO.: LEGAL DESCRIPIrION:
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BUILDING OWNER NAME: /4 �nn15 T'i7LL D / 1 RECEIVE®
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NAME: S PI•+0 /• C
I'�C�Y E 42013 c
ADDRESS: /Z.1, Z I Skyvl'eiw 1 CSV PERMIT CFNTFR
CITY: 51)ok4 tAe., VA (1, STATE: 1144 4 S U i'a yam, I IP: REV. r'F F
PHONE: GC)j 1/b i 6-35-7 FAX: !___ ,.m .__ _. ._. _—____I
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS: h' k e, 6 e4 i U-cu-cer 8r-6 s //6 If ��� /56
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CITY: .5� v e (A STATE: 4"T ZIp: Ti Zz7 ^66(02
PHONE: 5a L '5-3 3' `V / FAX: CELL:
CONTRACTOR LICENSE No.: I'�R B8C 1 "EXPIRES: 3/3// f crrY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: NM__ Dimensions: . 4 No. of Stories: Aj/,^ Total Habitable Sp A:
Main Floor SQ FT:iu/A Upper Floor SQ FT: /U/)m Unfinished Bas e Basement SQ Finished Bas4SQ
FT: Aillf FT:
Garage SQ FT: Deck/Covered Patio SQ Impervious Surfacerea: 30%Slopes on perty:
N/4 Fr: hi N4 V4
No. of Bedrooms: Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ ZIT$`( ,0 0
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.
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Signature , Date:
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REVIEWED FOR CODE COMPLIANCE j
SPOKANE VALLEY B ILDING DIVE •
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