2012, 07-17 Permit App: BLD-2012-1126 Addition i
Community Development DepartmentDrO eCt( taff Use Only)
Permit Center 1
11703 East Sprague Avenue, Suite B-3 PERMIT raECE1VED
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Spokane Valley, WA 99206
Tel: (509) 688-0036 PERMIT FEE:
ley , Fax: (509) 688-0037 JUL 1 / 2012
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permitcenter@spokanevallev.orq
CSV PERMIT CENT
RESIDENTIAL CONSTRUCTION PERMIT APPkICIATIONv # [
NEW CONSTRUCTION t, ADDITION/REMODEL 11,\ ACCESSORY BUILDING �_
El DECK Ej`�' / /�O,T,HER ,�t
SITE ADDRESS: ?6/3 /�/ Q/ECrCi I2' Si �he li61 1 1 lit/ 1"1 7f---/6
ASSESSORS PARCEL NO.: 7S-291%.2... f3'/6 LEGAL DESCRIPTION:
BUILDING OWNER NAME: (';p Tatty) tivstii
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ADDRESS: 1/6/c , . /L pj—(c rI nI
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CITY: cr(JikLTha V�/.IICY STATE: (,) I ZIP: 577:2/6
PHONE: YCI - 9 - 02-o Y, FAX: CELL: p y ??-5,_ 3.0?
CONTACT NAME: /`$'/ P\;151)5i 0
PHONE: 5 yT p-�
O - 3 - l37.5FAX: CELL:
CONTRACTOR NAME: I/ /
MAILING ADDRESS: CYC C�+ ley
• 1G4 i 21
CITY: S f�011 ye7, 1Jo/ly STATE: LAj 411 ZIP: 97z 6
PHONE: SCI'7', 3 7 17--" /c/,5' FAX: CELL: /
CONTRACTOR LICENSE No.:IjC�'m.C'rrC,?,3 ytvl E EXPIRES: ^7•. 5.-- &22.,'3 CITY BUSINESS LICENSE NO.: 4,76 'MI
/DESCRIBE THE SCOLP/EJ OF WORK INN DETAIL AND IND CATS USE & PROPOSED USE: /
er ,v✓- 'N- /c. —' 034,^ i, '1P ,�,f7, krk`t L✓ J, 1 rt ''
boo"e.
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: i Dimensions: ,,1 No. of Stories: / Total Habitable
1 ,2,� �x Space: ,-r r
Main Floor SQ FT: Upper Floo SQ FT: Unfinished Basement SQ Finished Basement SQ
5-3r ..`,/74 FT: ,V//4 FT: A.//041
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
7/Y FT: /WA? Area: ,(//�y Property: rk,/A,
No. of Bedrooms: / Construction Type:(cAvs.40 Heat Source: L41,1-71•.a Sewer or Septic: <'r-n -
TOTAL COST OF PROJECT: $ Oc:'" p
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 required to be submitted and subsequently approved before this application can be processed.
i .-,Signature ;'). -1 — �� / Date:
BD-02 V-1 //
Page 1 of 2
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ECEIVED %i75 A/. al'.-{ el
JUL 1 7 2012 �-
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�, PLANNIN DEPT. APPROVED
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