2016, 04-11 Permit App: BLD-2016-1201 Addition '61-1). -o�
Project --
Community& Economic Development
Department R E CAEAi LEECtonly)
Permit Center gC ! '
SC f ( 11707 East Sprague Avenue, Suite 108
PERT u�6
Spokane Valley, WA 99206 " 14`' i ��
Tel: (509) 720-5240 i PERMIT FEE:
Fax: (509) 688-0037 j
400 permitcenterOspokanevallev.orq
(2. V i-'t_1-', III l_,LIN I t;-i
SUB ,✓. i
l_ ; I
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION ADDITION/REMODEL ❑ ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: 2.2.14 5. G•,JICLIIJ 1.D_ 5lrmlckxl,— ✓.,LL..ty, WA- 1103
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK BOX,IF MAIN CONTACTA:
NAME: 7:)44 g_ k),(ubS.,J
ADDRESS: ZZ IA. S. Gon►ICLIw( C...0
CITY: 5r4.14,44%.•E ✓4t_LOf STATE: WA ZIP: `ter O5-4•
PHONE: Soil-2.SO-W44:26 FAX: EMAIL:
CONTACT NAME:
PHONE: FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX,IF MAIN CONTACT ❑):
MAILING ADDRESS: —
CITY: STATE: ZIP: —
PHONE: —, FAX: EMAIL: —
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
DrstA0 1,4 T7uL Le rt- r4 R-I I'r(.,,4 LA,* /ICC-4.,e R K Tp Su ITE-. v..1>K.4_4,2 4-61•44C
•.....114L . NlwS /i. 4,.tis .
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No. of Stories: Total Habitable
7414 414 z Space: 4,•sa Sat
Main Floor SQ FT: Upper Floor SQ FT: Unfinishedasement SQ Finished Basement SQ
Z,000 4[a FT: 4 I , FT: Z, e.o
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30% Slopes on
4/A FT: r4/4 Area: si iii.
- Property: 7.464
No. of Bedrooms: 3 Construction Type: SS Heat Source:4,4S Sewer or Septic:l5cw1u.
TOTAL COST OF PROJECT: $ 5500
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 b re ired to submitted3nd subsequently approved before this application can be processed.
Signature / ,... Date: 'f'II ZhF