2013, 03-13 Permit App: BLD-2013-0419 Reroof03/13/2013 08:44 FAX
- Res1dexTtial_Construction_Perrnit_Application.pdf
poane
4. F alley•
IA 0002/0003
http://www.spokanevalley.org/filestorage/l 24/938/210/94t8/33j Resid..
Commurity Development Department
Permit Center
'IbE;Hrl'e-Vbfie-cf ;WA g9206 -
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenteresookanevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION 0 ADDITION/REMODEL [] ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: 'Ma \ e. 4 1 Wt\ SaC VXI v\A- kA-) ct 5? -6(-4'
ASSESSORS PARCEL NO.: +4Btt44 , ()2t.2 LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: (_'C -AC x(1..'(Y1dU"'..\
ADDRESS: i \ L9 \ Ci V Q -L�R k..oQ,.L.k r ^
CITY: Sic L c i1t.a 4 & V STATE: �.1.}J ZIP: qq- (o
PHONE: k_gt-4-11
CONTACT NAME:
FAX: CELL:
PHONE:
FAX: CELL:
CONTRACTOR NAME: JGAj `^-'i1 YDV ll -1/
MAILING ADDRESS: t\t-k-/„7
CITY:yti�[(q.� q
PHONE: F0�' [Z —t -ft ?AD
STATE: k j Y�
FAX: 1:0-6 - �SI V CELL'
ZIP: lct2.000
CONTRACTOR LICENSE NO.: WA/ fkyFA:SULe. i!tit EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
%�/L OcG,°%Ze o
****YOU MUST COMPLETE THE FOLLOWING****
_ MARK NIA IF NOT APPLICABLE
Height to Peak: � ' Dimensions: No. of Stories: I Total Habitable
tv ki Space: —
Main Floor SQ FT: 1 Upper Floor SQ FT: Unfinished Basement SQ I Finished Basement SQ
— FT: FT;
Garage SQ FT: Deck/Covered Patio SQ : Impervious Surface ' 304/4 Slopes on I,
FT: _ Area: — Property: I: •
No. of Bedrooms: : Construction Type: Heat Source: Sewer or Sepric: If
TOTAL COST OF PROJECT: $ 3t -t12. 10
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if tis permit is for construction or on a dwelling, the dweltirg is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit Inure to Me property owner. 3) The signatory s the property
owner a- has permission to represent the property owner in this transacbon. 4) All construction is to be done in full compliance with the Ci -y of
Spokane Valley Development code. Referenced codes are available for review et the City of Spokane Valley Permit Center. 5) The City or
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or addtior.t::
information may be required to be submitted and subsequently approved before this application can be processed.
Effective October 28, 2007 Page 1 of
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residentiai Construction Permit
App 10.28.07.doc
1 oft 3/12/20I3::::.i