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2012, 09-24 Permit App: BLD-2012-1660 Pole BldgSciiiikane ("Immunity Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 720-2540 Fax: (509) 688-0037 permitcenter@spokaneval lev.orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: Project 7 - !2- `/b RESIDENTIAL CONSTRUCTION PERMIT APPLICATION 0 NEW CONSTRUCTION 0 ADDITION/REMODEL ACCESSORY BUILDING 0 DECK 0 OTHER SITE ADDRESS: 'S--7 T3i4 S . U `ilk `Spo ,C) IU -'4`9 Q oa C Lo ASSESSORS PARCEL NO.: 3?,( 214(:) LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: P\\ er1 \ IVLq' ADDRESS: '-'673� S. \ n Cm: PHONE: STATE: U,...\3‘ ZIP: C 9 acs �o FAX: CELL: CONTACT NAME: ](')`\ 6 ¶>Av iC CYC PHONE: FAX: -77t CONTRACTOR NAME: cj Q t i ¶3' Cki A V --P CELL: MAILING ADDRESS: CITY: Cbl _>OiL.u`I , / PHONE: q -( 6�j l - 77(oq FAX: STATE: L& Pr ZIP: q al c.3.1 CELL: CONTRACTOR LICENSE No.: SOLI t)SL-C 1() EXPIRES: 14/ 0() t, 3 CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN ETAIL AND INDICATE USE & PROPOSED USE: 3(<c< 1,o ado k���.1(L Y c\ ****YOU MUST COMPLETE THE FOLLOWING**** NIA IF NOT APPLICABLE Height to Peak: 1 I Dimensions: 3e) SD No. of Stories: l Total Habitable NI Space: IcN Main Floor SQ FT: iUpper l• -j A Floor SQ ll Oc Unfinished Basement SQ FT: I A Finished Basement SQ FT: N) Y--‘ Garage SQ FT: I cJ Deck/Covered Patio SQ FT: 0) Pk Impervious Surface Area: ' q 4 Z , 30% Slopes on Property: tJ i YA No. of Bedrooms: Kip Construction Type: Nie 0 Heat Source: 1\31 P Sewer or Septic: TOTAL COST OF PROJECT: $ 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 approva •= -tion of federal, state or local laws, codes or ordinances. 6) Plans or additional Information may be required to be subml =- - d subsequently a..roved before this application can be processed. 4-,r6c-ex) Signat Date: ( _2 2.c j - Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit-_Residential_11-11-11.doc cz• l'''"" 15-3/ - 3 </o 5 PLANNING DEPT. APPROVED LLJ h- 4'7>