2013, 07-17 Permit App: BLD-2013-1383 Pole Bldg lr NI
Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Q Spokane Valley, WA 99206
CITY+ Tel: (509)688-0036 PERMIT FEE:
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Fax: (509)688-0037
permitcenterC�spokanevallev.orq
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK r 0 OTHER
SITE ADDRESS: ` dj E, do 1i
ASSESSORS PARCEL NO.:1,5!3V. /,/s� LEGAL DESCRIPTION:
BUILDING OWNER NAME: GeC)Rei &3/\j'1f.
NAME:
ADDRESS:
Cm: SPOKANE VALLEY STATE: WA ZIP:
PHONE: [ Z 7- 39 2 FAX: CELL:
CONTACT NAME: LA geRy /c)1,30 e(2 ce/J I)A Ye 13E'14aor3'tJ
PHONE: 722 _cospiAX:d12q 410• T CELL:
CONTRACTOR NAME: 9U ((dos COfY? ein4C5 .Z-A/C
MAILING ADDRESS: /lo 02, 11 E, V pR t.4` !3 u-e_.
Cm: SPOKANE VALLEY STATE: WA ZIP: o3 7
PHONE: ?2 Z - (43 9.5e FAX: 92'e-fd 9 CELL:
CONTRACTOR LICENSE No.: BULLDCI933M5 EXPIRES: 7/25/13 CITY BUSINESS LICENSE NO.: BULLDCIi
DESCRIBE THE SCOPE OF WORK IN DETAIL AND,I CATE U(!5oa
& PROPOSED USE:
Ccs N 52-U4' c• - i> pc)1 13—r iiI5 ,4- L- dog
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: t4 i Dimensions: No.of Stories: Total Habitable..........------4.` Z � Z l Space:
Main Floor SQFT��J Upper Floor SQ FT: i Unfinished Basem en
SQ Finished Basemt
4' FT: FT:
Garage SQ FT: Deck/Covered Patio Q Impervious Surface 30%Slopes on
/*'-"------ FT: Area: ../.-- Property:
No.of Bedrooms: Construction Typer
Ie. Heat Source: /-- Sewer or Septic:,..-----
TOTAL COST OF PROSECT: $ i- f<
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 per ' ion to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley 0- I pment code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley .- is Lt a permit or approval for any violation of federal, state or local laws,codes or ordinances. 6) Plans or additional
information may .- • ui to be submitted and subsequently approved before this application can be processed.
EffectiOil
•-r 8, 2007 Page 1 of 2
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App 10.28.07.doc
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