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2014, 05-21 Permit App: BLD-2014-1139 Tear Off, Reroof Project # .60 1 c .., - RECEIVED J i Community Development Department (St/44Q 4nalll II- Permit Center µ 11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER: c°tryctSpokane Spokane Valley, 03 44206 EPMIT CENTTel: (509)688 0036 PERMIT rfE: Fax: (509)688-0037 �U� a " E:t Valley rmit4enter 5pakanevaiiev•orclI RESIDENTIAL CONSTRUCTION PERMIT APPLICATION 0 NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCESSORY BUILDING 0 DECK ,® OTHER Kush, ) SITE ADDRESS: I TI 5C 5. Lun u f.c':tt1 ° tc E CR,tAl FAA \-0R• el�aSa ASSESSORS PARCEL NO.: . BUILDING OWNER NAME:T c 'o . a,\osOY\ NAME: ait-b pt ')bson ADDRESS: I 'ct c 47. tit.°1 De_r SM..) { nC�' CITY: .0 QL U �t W(�, STATE: ZIP: (311 al al 3, PHONE: FAX CELL: CONTACT NAME: PHONE: n FAX: CELL: CONTRACTOR NAME: 1)r,p mtt r 1`RQo&') J l-0ritr�-C4i r..S MAILING ADDRESS: p{IQ©4 JO . 0_,.0 Lf.,, -a''r R' /� ` CITY: S,g{)Vl('1/Y\4 .0 ovj STATE:. �+-w ft ZIP: T3 -{ i � PHONE: `�j(C��1 a)it 105'46 FAX:SO9 �j)., /I CELL: S%-CA a,�O at4�3 03 CONTRACTOR LICENSE No.:P(2MItC, tat CJg EXPIRES:///5 CITY BUSINESS LICENSE NO.DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE: ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: Dimensions: No.of Stories: Total Habitable Space: Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished ished Basement SQ FT: Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on FT: Area: Property: No.of Bedrooms: Construction Type:Rppf imi Heat Source: Sewer or Septic: TOTAL COST OF PROJECT: $ (::?a9L). 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)oradd Ci ynoy f Spokane Valley permit is not a permit or approval for any violationrof ovee beforean, tateis oraplocal catt laws, con od spor ordinances. 6) l information may be required to be submitted and subsequently app ssed. Page 1 of 2 Effective October 28,2007 P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doC COPY TOTAL BUILDING S FT: TYPE OF PROTECT: �O�r k� FIRE SPRINKLERS: HEAT SOURCE: SQ FOOTAGE: PRIMARY OCCUPANCY: SQ FOOTAGE: SECONDARY OCCUPANCY: ( — TOTAL COST OF PROTECT: $ • t DISCLAIMER agrees bytheir signature that:1)If this permit Is for construction or on a dwelling,the dwelling is/will The permitted potable acknowledgestr. wand The signatory is the property be ownerserved hasy water. 2)Ownership of propertyhis o net In this transaty of Spokane lction. 4)t Allconstruction is to be done n)full compliance with the City of Spokane permission to code. the The City of permit Is not a permit or approval for any violation of federal,state or local laws,codes or ordinances. 6) Plans or additional Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. Spokane Valleymapplication can be processed. information may be required to be submitted and subsequently approved before this Date: Signature Method of payment: 0 Cash 0 Check A`Visa ❑ Mastercard • Bankcard # REDACTED REDACTED REDACTED E; Authorized Signature: This document originally contained confidential credit card information which was redacted pursuant to RCW 19.255.010 and the original document destroyed pursuant to SOS DAN GS2014-030. Paoe 2 of 2 Effective October 28.2007