2015, 03-23 Permit App: BLD-2015-0612 Pole Bldg Addition _151-1)-2•01 --tgaia-
Sin) 11707 E Sprague Ave,Suite 105
,.Valley Spokane Valley,WA 99206 Project 21�
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(509)508-0036 FAX:(509)58S-0037 R E C E I V D
Community Development www'.sookanevallevr.or_
L6AMA2, 2 3 2015
Residential Construction U New Construction E Accessory Bldg
Permit Application Eg#Addition/Reti6der EFEEIDIaLATER
C Other: SUB # 1 ti REV, #
SITE ADDRESS
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building Omer: Contractor -
Name: 1^,'11,,c_ d`/..)i.00 c2- C 0✓tA hl Name: .5p0o )S- R„ut
Address: .. abu,✓L Address: 12_ el . 2a .js,
City: °kv® 5vIAND us State: t . Zip:g'12at City: Sm444t,...\),,4,44.4State: Zip12�`t_
Phone: llG3 _ 6 Fax: Phone Zr -0o1:05- Fax: er 2`t- 1-Li
LL 6 C —'-- g�rc i,GNrlot
ti`� Exp Date:
Con>tact:Persoti - _ - -_ • City Business Lic.No:
Name: ou -- ,
Phone: 9 tL —cii LT
Describe the scope of work in detail: Cost of Project: $ D UC)0
VI"- 3)' )c $' tL --v Ate= Dm
**************The following MUST be complete: (write N/A if not applicable)*********************4
HEIGHT TO PEAK: DIMENyJONS: #OF STORIES: ih TOTAL HABITABLE SPACE
9y 12 `E• 3 J __4 -
MAIN FLOOR TO SQ. 2""FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG: .)a----- (=-::)". - fOt--- AREA:
FINISHED BASEMENT GARAGE.11Q. FT : . DECK/GOV.Pf LT SQ. FTG: 30%SLOPES ON,
SQ. FTG: $ �-� PROPERTY: _
#OF BEDROOMS: C STRU cI TYPE: HEAT SOURCE: )-- SEWER SEPTIC?
The permitee verifies,acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling,the
dwelling isfwill tie,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) A11 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) This 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 may be required to be submitted,and subsequently approved before
this application can be processed.
Signature r—Vp._- Date 3123 l
Method of Payment:
0 Cash I4eck 0 Mastercard 0 VISA
Bankcard#: Expires: VIN#:
Authorized Signature:
REVISED 8.252DD5