2015, 05-18 Permit App: BLD-2015-1134 Residencei$ 751606
Permit Center
C'(K
®i ane 11707 E Sprague Ave, Suite 106
...01011gValley
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevatley.org.com
Residential Construction
Permit Application
CE1VEU
s t u < : 21115
;to New Construction
o Addition/Remodel
o Other:
loY
4-111 41*
o Accessory Bldg
o Deck
SITE ADDRESS 11 30 7 £ _ SwAdow A Dr
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: (.q,t Z Q / - L 5 it P- o4 -/d
1Yur
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Name: act oncyva
12cJ- Coyts -1---
Address: Address:
Phone: 9 2 Cl - Siy 6 c.( Fax: 9'76-- $(}
City:
Zip:
Phone:
Fax:
o_, a t
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Jame:
'hone: --L,‘ % - g 9 Z y
describe the scope of work in detail:
:. ' 0.l - cYn.pM1 .� `1
•_ °P12114 -%...a.. ., 4414,4---%, .t ingF . i; .fi rTF'' .,,,, `�-A--- <aF ...,..
Name: OT c -14 A411 G /6_ Ca'4S f
# OF STORIES: '
Address: 7 (, O 7 /I% S u //1.11411. AC1
City: sIo rAgAt 04,7 Zip: 99z1.
2N0 FLOOR SQ. FTG:
0
Phone: 9 2 Cl - Siy 6 c.( Fax: 9'76-- $(}
91/
Lic No: .Exp. Date:
_
City Business Lic No:
DECK/COV. PATIO SQ. FTG:
11 g
Cost of Project:
*************The following MUST be complete: (write N/A if not applicable)**************
[EIGHT TO PEAK: ZZ1
DIMENSIONS:5SXG/ 6„
# OF STORIES: '
TOTAL HABITABLE SPACE:
i73
IAIN FLOOR TO SQ.
TG: l 733
2N0 FLOOR SQ. FTG:
0
UNFIN BASEMENT SQ. FTG:
�l
IMPERVIOUS SURFACE
AREA:
INQ I HED BASEMENT
FTG: 0
GARAGE SQ. FTG:
7Z
DECK/COV. PATIO SQ. FTG:
11 g
30% SLOPES ON
PROPERTY: N/k
OF BEDROOMS: 3
CONSTRUCTION TYPE:
Woos) Fra.ri.e
HEAT SOURCE:
Na,f'.r 1 64..5 Fv-rnli.C_
SEWER OR SEPTIC?
4. rer
ISCLAIMER
permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
veiling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
3natory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
)okane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
:al laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
s application can be processed.
gnature
Date
?thod of Payment: (Faxed permit applications will only be accepted with major bankcard)
Cash ❑ Check ❑ Mastercard ❑ VISA
Inkcard #: Expires: VIN#:
Ithorized Signature:
(ISED B/25/2005
❑ Other