2013, 11-19 Permit App: BLD-2013-2395 RemodelPrc�iPct # '%O11J—�3g5
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-
SCITyof ®! Spokane Valley, WA 99206
pokane Tel: (509) 688-0036
Fax: 688-0037
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permitcenitcenter(asaokanevallev.orq
41010
STIR ` fl
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION 0,.,ADDITION/REMODEL E ACCESSORY BUILDING
JJ DECK e/ ID OTHER
,Z'/',f ADDRESS: X41 /,� ��t/��1� tic /E 01.- ••.
ASSESSORS PARCEL O.: c 0 //, %/� LEGAL DESCRIPTION: .5'0 tii,/(Ale /-Audi Gd g
BUILDING OWNER NAME:
Pei) ,cl /4 k,
1V //a N .$upv,/(A/c, /.- -
�
CITY: � Jo kc'? i/C /f7' STATE:/1 ,,4- ZIP: 5, i ,7 ` V
(
PHONE: ,Q).7. 5.,^ / 6/Pl Ct 3 . FAX: /J/J CELL: fc) •-17 ? .
CONTACT NAME:
PHONE: ,Sesi, e;',5 �a X7Gf,_ FAX: CELL:
CONTRACTOR NAME:
NAME:
ADDRESS:
MAILING ADDRESS:
CITY:
:
STATE:
ZIP:,
PHONE:
FAX:
CELL:
CONTRACTOR LICENSE No.:
EXPIRES:
CITY BUSINESS LICENSE NO.: •
DESCRIBE THE SCOPE OF WORK IN D,ETAyAND INDICATE USE & PROPOSED USE:
�°
J/ f: t.
****YOU MUST COMPLETE THE FOLLOWING****
A IF NOT APPLICABLE
Height to Peak: Al
Dimensions: � ��
R 1 /
No. of Stories:
Totall Habitee ��
Space:
Main Floor SQ FT:A/
Upper Floor SQ FT:
"/
Unfinished Basem nt SQ
FT: j /3-
Finished Basement Q
FT: %V/
/Y
Garage SQ FT:
Alk
Deck/Covered Patio SQ
FT: n/ 19-
Impervious Surface
Area: 11/4"
30% Slopes on
Property: N*.
No. of Bedrooms: AI n
Construction Type: e.,-hi/e__
Heat Source: <
ewe • or Septic:
TOTAL COST OF PROJECT: $ A4- c
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 requir-. to be submitted and subsequently approved before this application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Buiiding_Permlt=Residential_11-11-11.doc
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