2015, 05-18 Permit App: BLD-2015-1137 ResidencePermit Center t/liy -3-6-I537T7'''7
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S Okane 11707 E Sprague Ave, Suite 106
4.0000Valley
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevalley.org.com
Residential Construction
Permit Application
0 -New Construction
S ❑ Addition/Remodel
o Other:
o Accessory Bldg
❑ Deck
SITE ADDRESS 11311 E. S d i ri
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: LO f 3 Sff P - O 9 -/0
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Phone: 92 `f F9.6V Fax: 9 Z6- f6 9
Lic No: .Exp. Date:
Name: (7 i A,vwi 0
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Address:
30% SLOPES ON
PROPERTY: Nit}
OF BEDROOMS:-.7CONSTRUCTION
ISCLAIMER
TYPE:
(goad Fra.nne
City:
Zip:
Phone:
Fax:
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name:
'hone:
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Describe the scope of work in detail:
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Name: 0iG.✓Nari1 RaC4 Cern s 7.---
"Address:
Address:Z 6 Z At Sk /// i/f ,Z gel
City: s 2 J/t.e_ 1//(ex Zip: 99r16
Phone: 92 `f F9.6V Fax: 9 Z6- f6 9
Lic No: .Exp. Date:
City Business Lic No:
Cost of Project:
*************The following MUST be complete: (write N/A if not applicable)**********************
EIGHT TO PEAK: z I
DIMENSIONS: S Z / ,
# OF STORIES: /
TOTAL HABITABLE SPACE:
1566
IAIN FLOOR TO SQ.
'TG:15 / 6,
2Nu FLOOR SQ. FTG:
P
UNFIN BASEMENT SQ. FTG:
P
IMPERVIOUS SURFACE
AREA:
INISHED BAS MENT
Q. FTG:
GARAGE SQ. FTG:
jZ Z
DECK/COV. PATIO SQ. FTG:
0
30% SLOPES ON
PROPERTY: Nit}
OF BEDROOMS:-.7CONSTRUCTION
ISCLAIMER
TYPE:
(goad Fra.nne
HEAT SOURCE:
Na z+/ Ger Fu c-
SEWER OR SEPTIC?
- S-e&J&r-
permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
Melling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
gnatory 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
cal laws, codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before
is application c�a�eprocessed.
gnature
Date
ethod of Payment: (Faxed permit applications will only be accepted with major bankcard)
Cash ❑ Check ❑ Mastercard 0 VISA
rnkcard #: Expires: VIN#:
❑ Other
ithorized Signature:
JISED 8/25/2005