2015, 01-21 Permit App: BLD-2015-0106 Pole Bldg Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
SpokaS
�T,,.�oka„e Spokane Valley, WA 99206
ne Tel: (509) 720-5240 PERMIT FEE:
ValleFax: 688-0037
y .
permitcenitcenter@spokanevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL ORY BUILDING
El DECK 1 OTHER Projecty '`'_
SITE ADDRESS: I S; 2 2 E t\l ' I, ` All 1L - I~�O(0,
ASSESSORS PARCEL NO.: y 501 2: t OZ LEGAL DESC• PTION: I V ,j I
1
OWNER/APPLICANT (CHECK BOX,IF MAIN CONTACT n):
NAME: Pi Off
. I' M t,t)(Cut I CS I F?E�1
f� j MIT CENTER
ADDRESS: 1 L.2 b Q 1 _ t C�
,
CITY: M h 1 R\/ci vtt `\1 :CA- STATE: A �e---r-------------__ _ P: R� �I' ) t
"'111
PHONE: Oq - q,oi - `"1 Lao---/ FAX: EMAIL:
CONTACT NAME:( fk-��1(' ��`�
1dQ Pe w-p 1 I 1
PHONE: j(..\' 1 Ce,1 -I-7 Le 9 FAX: 5 C N..-7N..-7 - �7 g 33 EMAIL: ( 1�St'J[I si-ru C i i b('j cu.f_.)
CONTRACTOR NAME (CHECK BOX,IF MAIN CONTACT: r i� CC/�
MAILING ADDRESS: LO 1 24 IN O ItJ b U- I' (�
CITY: S�,((1(a f 'I Q CST(A�TE:� tA 0 ZIP: "I "� Q- ) 1
PHONE: 509 `i Zj� - ( 1 1.09 i FAX: )(-)c) - `l�.'7 - 703 33 EMAIL:
CONTRACTOR LICENSE No.: SOLI OSLO !O”(EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
40 X )() X t 2 :)(-)_� ACAik
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No. of Stories: Total Habitable Nlf�
I • - L x 3b I Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
131A i,)_/A FT: it\ A FT: K.)/
Garage SQ FT: Deck/Covered'Patio SQ Impervious Surface 30%Slopes on
1200 sci ft FT:
FT: ,..J/ Area: :32_1 0 sq re- Property:
No. of Bedrooms: (n Construction Type: Va Heat Source: 011+ Sewer or Septic: %/ag°
TOTAL COST OF PROJECT: $ 31 , 000
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 maybe- quired to be submit_ subsequently approved before this application can be processed.
/'.' Date: /" /9 / 5
Signatur,;e' ---
. . .
? 1/161)0 A. MU OA PLANNING DEPT. APPROVED
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q-pli IS
DATE:
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Project #-.1a....1P-411. -OW ,
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