2016, 03-09 Permit App: BLD-2016-0922 Pole Building Pro'eet �i3C-.� �/6-pet Z.�
Community Development Department R E fir# ons)
• Permit Center
11703 East Sprague Avenue, Suite B-3 PE
}� 16 1
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Spokane Valley, WA 99206 t"IN "
Tel: (509) 720-2540 PERMIT FEED
lift. ..'":"1;Valley. Fax: (509)688-0037
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SUB # ( REV. # 1 j
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION 0 ADDITION/REMODEL E ACCESSORY BUILDING
❑ DECK ❑ OTHER
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SITE ADDRESS: , () A t55(("11') -. Ve.. 5 .)--a-i V(,t. , 1N,
ASSESSORS PARCEL NO.: I. D6! I LEGAL DESCRIPTION:-n_ Yl&-SY15-k1Cj N IV
BUILDING OWNER NAME:SI LV'A EX() NuDrTV L •Z.3
NAME: Lail l y(�,ci a.p. Silver
ADDRESS:Cie,/01' 0./1/`.�-ii 1S✓fir Ave. ,
CITY: ��llK-Cl V1.^t�. Y K -1 STATE: t\JA ZIP: eI c1 G- 2
PHONE: �- Z4 i -30�K
Pau: cELL:
CONTACT NAME: Shasta.- isolO
PHONE: 5r; - 4S (- -771 Co -l FAX: 50C1 -32-7-'12-33 CELL: 5(C - g44- U4l Le
CONTRACTOR NAME: SOLI C) 1tUC T l L k E' 14._...c,
MAILING ADDRESS: (1124 IV . Pi SV l
14111' CITY: (Ica_
LCU)e STATE: WA ZIP: 17
PHONE:
TO
- 4g 1 - 71061 FAX:��r:j- --�-7 2
�'1 ��- /(i"JJ CELL:
CONTRACTOR LICENSE No.:J i OL Qj 14 EXPIRES: (2_01co.. CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
N 5(20x 14 Pvir,' uItCtIiu --- — - —
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: 2l , Dime s ( No. of Stories: Total Habitable
>< . i A VSpace: _._
Main Floor SQ FT: Upper Floor SQ FT:! Unfinished Basement SQ Finished Basement SQ
FT: FT: -_-
Garage SQ FT: Deck/Coveted Patio SQ Impervious Surface 30%Slopes on
FT: - -- Area: 440 i Property: - - --- -
No. of Bedrooms: -- Cor on Type: Y i5Heat Source; — Sewer or Septic: -
TOTAL COST OF PROSECT: $ )'ZOd
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
owner or has perm�sion toSpokane Valley permit inure to the property owner. 3) The signatory B the property
Snkane Ya represent the property owner in this transaction. 4) Ali construction is to be done in full compliance with the City of
Development cue. 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 required to be submitted and&suOsequentJy approved before this application can be processed.
460, Signatu /; t
I(.— /C b' I
lak e, -t Date: 1 G i zu t p
Updated i-11-11
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http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit=_Residential_11-11-11.doc