2015, 05-22 Permit App: BLD-2015-1209 Repair Water Damage AY-22-2015 14:19 FROM:A1GENERAL 5093284772 TO:6880037 P.1/23
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j Community Development Department (Stall Use Only)
Permit Center i
11703 East Sprague Avenue, Suite 3-3 l PERMIT NUMBER:
Sjôkane
Spokane Valley,VdA 99206 PERMIT FEE:
7e1: (509) 720-5240
Fax: (509) 688-0037 ]n
.: 4000Valeye p,rm1��;<rer��Rokanevallev.orQ Project _ N : i,5 J1c'O
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RECEIC
VED
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION El ADDITION/REMODEL i AS
61i4tSUILD N
E OTHER
DECK �j w+,� �,;_, , ' ^Er�TER
SITE ADDRESS: I lip �- _ 1 -e 1 d U _r_ -
PARCEL NO.: LEGAL_DESC ±PTION: .-'7-7:‘,,: w _ —_r—
ASSESSORS _
OWNER/APPLICANT (checx BOX,.IF MAIN CONTACT❑):
ICV"/NAME: k1v.71 N
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' ADDRESS: 1 1'I a V"/ fr_, '^C�5-ie-1 -V`+.0 Ie J l !-- �1
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PHONE:
CITY: _..0‘--
c . ✓ ` '^C STATE: W"t ..+. ZIP:
3/� 3 I
1FAX EMAIL:
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' CONTACT NAME: --
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PHONE:
—PHONE: _
FAX: EMAIL:
CONTRACTOR NAME (CHECK Box,IF MAIN CONTACTl): A --. 1 G•r It1re" -S't c
MAILING ADDRESS: 4`,/�-0 /V• ,_1 ti 1 _ •
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CI Y: S l A�.I— STATE: WF ZIP: qq! 0
PHONE: sr/` .- - I o c C PAX: '3 9r' 4 7 0— EMAIL:
2 WV BUSINESS LICENSE NO.:
CONTRACTOR LICENSE NO.�([TN'C�oq 1 D I EXPIRES!"6 r 5i` ..._
DESCRIBE THE SCOP OF WORK IN DETAIL AND INDICATE USE & PROPOSED
USE:
` 01 ' 't( ,. .w e seri lr�Lt� l�.cl t h h_�r_. s
t - (c c c I__Lf -'S_ w l It :_ :t'
--- ****YOU MUST COMPLETE THE FOLLOWI_NG* ±
MARK,NIA IF)VOT AP?LIC .
Height to Peak: Dimensions: No. of stories: Total Habitable
• Space:
Main Floor SQ FT: upper Floor SQ PT: ' Unfinished Basement SQ finished Basement SQ
E FT: _ FT:
garage SQ FT: Deck/Covered Patio SQ IAmpaervious Surface 30%3lloopes on
FT:
roperty:
No.of Bedrooms: _ Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROSECT: $ '( 2._ ( q . '
PISCLAXMES
The permitted verifies, acknowledges and agrees by thein signature that: d) 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 nr 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 or 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 informatio may be required to be submitted and subsequently?approved before this application can be processed.
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Si nature _ Date:
Received Time May, 22. 2015 2: 34PM No, 1907