2013, 05-30 Permit App: BLD-2013-0998 Pool r
Project #z 3ici -t3 - e
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Community Development Departm=nt (Staff Use Only)
Permit Center A'� ry f�yq
11703 East Sprague Avenue,Suite=-3 P1RMI�r MBERC 3 1
SCITy�kane Spokane Valley,WA 99206 p� Lp�E _
Tel: (509)688-0036 64.V l-i,E j
41111101.1.111°.Valley Fax: (509)688-0037
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK0OTHER
SIttADDRESS: -7i2 5 r v/ 74 I° ‘./I`,/
ASS$SORS PARCEL NO.: g53L{L,-,-3D‘:)0 LEGAL DESCRIPTION:
BUI\L'OYNG OWNER NAME: K-aretti «aN0)
NAME: `�
ADDRESS: U 7'Z {S. (Yi/rj'!/4, i.A/
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CITY:`^� 0Ka btu Vett ✓ STATE: W� ZIP: 7T-2 OG
FAX: CELL:
PHONE:
CONTACT NAME:
FAX: CELL:
PHONE: /�
CONTRACTOR NAME: AQUIt El t-f e-- Po of I SPA.Z�('a
MAILING ADDRESS: /32( E �" r„,vSL_— �
r, \A 1 4.. STATE: (�fn ZIP r'r q
,Z0 6
CITY:.S�O�q.lnJt- �
PHONE:Cs-07) J-36 77? - FAX: 92 Y 60>Y CELL:'
CONTRACTOR LICENSE No.:/'cQc.A.E Et-21310y ExPIREs:1-2 q(-2o ir CITY BUSINESS LICENSE NO.:&(..-1E -12 t/G
DESCRIBE THE SCOPE OF WORK IN DETAILL AND INDICATE USE &PROPOSED USE:
.,r f-4 (( /d e ( 55 ter,.,h,Pt,-
****YOU MUST COMPLETE THE FOLLOWING****
NARK NLA IF 149TAPP_LICABLE Total Habitable
Height to Peak: Dimensions: No.of Stories:
Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
FT: FT:
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
FT: Area: Property:
No.of Bedrooms:
Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ 4'0,5,
pISCLAIMER
The permitted verifies,acknowledges and agrees by their signature that: 1)if this permit Is for construction or on a dwelling,the Is the dwellingill
be served by potablemisont 2)Ownership of this City of owner in Spokane
his transaction.permit
Inure to the property owner.All construction is to be done n)full coe mpliance with the City of
owner
poka a Vas permission to represent. the property
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 fderal,e this,
ate oraplocal
o al lawons, od sprocessed.ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved
3
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Effective October 28,2007 Page 1 of 2
P:\Community Development\02 Administration\03 Formsp30O Dal Versions\Permit Center\Residential Construction Permit
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