2015, 03-31 Permit App: BLD-2015-0703 Pole Bldg . Community Development Department
Permit Center ProjJct kbff0-s6FIY)0'703
11703 East Sprague Avenue, Suite B-3PNBERL D
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pokane Tel: (509) 720-5240ley, 99206 C
Tel: anelleWA PERMIT FEE:
Valley. Fax: 688-0037 MAR 1 2015
permitcenitcenter@spokanevallev.org
40000
CSV PERMIT CENTER
RESIDENTIAL CONSTRUCTION PE ' .41., 3wiar C I
L.
0 NEW CONSTRUCTION 0 ADDITION/REMODEL ► ES80• - - - ' -
0 DECK 0 OTHER
SITE ADDRESS: 150044 Vat-t- `f L,iA
ASSESSORS PARCEL NO.: 1-151,-P-1 ., 1 5o0 LEGAL DESCRIPTION:
OWNER/APPLICANT (CHECK BOX,IF MAIN CONTACT
....-6
NAME: e_uc. _ VV' 4-L6N-0 LESS
SS / J
ADDRESS: E �q i,t,f�f 1AA ����. L
CITY: SPO gAN,r \AL.L._ y STATE: LAJ/� ZIP: _�� 'C3
PHONE: FAX: EMAIL:
CONTACT NAME:Sp
PHONE: _O�� 9 70 v .-/ FAX: EM/A�IIL:0
CONTRACTOR NAME (CHECK- BOX,IF MAIN CONTACT ❑): Z F G-(,, L uy'i %f- CD
MAILING ADDRESS:ES / n - 'l.11 COLL) � 40 L-L A J
3 6-05
CITY: C U�L JI- STATE: LAAA- ZIP: IL?q a/5
PHONE: 509-- LAO- `ACi(420 FAX: EMAIL:
CONTRACTOR LICENSE No.: Zl£G-L -*3i 6,v, EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
s- z 3- xL(2) 1 (0-- Po Li_ B_cG-
****YOU MUST COMPLETE THE FOLLOWING****
MARK N A IF NOT APPLICABLE
Height torPe k: Dimensions;
sions No. of Stories: Total Habitable
.P I Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
IN.A FT: N11tor FT: /JIYi-
Garage SQ FT: Deck/Covered Patio SQ Impervi us Surface 30% Slopes on
LX f FT: N 1/ Area: �j ev Property: t-) l4
No. of Bedrooms: N(/-1 Construction Type: Po l.&_ Heat Source: r'JM- Sewer or Septic: N)A-
TOTAL COST OF PROJECT: $ 1 0.170 w
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.
Signature AAA,/,ii �4(([2,tA'
. DatE Jam/ — / 5