2012, 06-18 Permit App: BLD-2012-0917 Residence Project #�—/Z- / 7
Community Development Department a , ;
Permit Center
�j,��, 11703 East Sprague Avenue, Suite B-3 PERMIT r'4 J ER: « ,
SnnlL!s�� Spokane Valley, WA 99206 JJUU�I�� II
VJL�►ull Tel: (509) 688-0036 PERMIT FEE!
Valley
permitcenter(c�spokanevallev.orq
SUB # E7 PEV. # =
RESIDENTIAL CONSTRUCTION PERMIT APPLIC
Igf NEW CONSTRUCTION El ADDITION/REMODEL ] ACCESSORY BUILDING
ill DECK 4' OTHER
SITE ADDRESS: SO5 N, 'iERLLrG(L
ASSESSORS PARCEL NO.: 45153, 2`tbg LEGAL DESCRIPTION: g.Av $ Loy 8 gLk I
BUILDING OWNER NAME:,/5� hmg, vkom ( - 9) .}� s iocis1 gK 3.5' 16 10)
NAME: N >pAc f`UY4Gj We— ,,,p -.( CaRtP-A.%)
ADDRESS: 1101 S�i 1 aCtk' CUN1r& O St,1(t 1L'0
CITY: Vprr1t;OVei- STATE: Wet ZIP: IVt.S3
PHONE: 604i) 1\t3- 31444 FAX: CELL:
CONTACT NAME: jet.! C pi
PHONE: C6-o°) Wil)a 14,14 Li FAX: CELL: C5"oq9 lets- qoi:,1
CONTRACTOR NAME: Icp419_ IkO' AC-S , ISL
MAILING ADDRESS: 121.2.1) t NOVA Avg gut 1
CITY: 5rov,,m E ' kael STATE: 1,,x A- ZIP:: 1 q`2110
PHONE: ( o ) q 39 g FAX: i CELL: C56J iqc- 9OCG0�y
CONTRACTOR LICENSE NO.: pDAW,VI4(742I i EXPIRES: 21 I3 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
B�1l.D1 .3 i. i>- 6Pet. Wovwf 11) 4g- vsrcp ft5 iet.0 atm SUE Vt4043CL t,tJP I Scat
pl•t R LIr 2i- OA1 .
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: 2.,0i Dimensions: 1 O X L)L' No. of Stories: ` Total Habitable 1851
Space:
Main Floor SQ FT: Uer Floor,SQ FT: Unfinished asement SQ Finished Baserpent SQ
i$5'� ppA-
FT: NIFT: NIik
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
4110 FT: L 1(e, Area: 141 a Property: N Ilk
No. of Bedrooms: 3 Construction Type: S11GU, Heat Source: Elle, (-u +,1 Sewer or Septic: 104C9.-
TOTAL
04C9.TOTAL COST OF PROJECT: $ it 1 fi(aeb
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 e req ' ed to be submit d subsequently approved before this application can be processed.
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&itg112
Effective Octob r 28, 2007 Page 1 of 2
P:\Community Development\ dministration\03 Forms-Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
Plot Plan
Name: Adair Homes-Model Home Spokane
Property Location: 505 N Vercler Rd,Spokane Valley,WA 99216
Legal Address: T: R: S: Q:
Tax Lot: 45153.2908 County: Spokane County State: WA
It is the homeowner's responsibility to identify
and locate all property corners and verify allAll)N iH
setbacks,easements,and other'restrictions that Scale: 1"=20'
' pertain to this property prior to construction.
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CSV PERMIT CENTER $2 Ny m,
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