2013, 03-26 Permit App: BLD-2013-0497 Addition Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue,Suite B-3pERMIT NUMSERG ,
Skane Spokane Valley,WA 99206
Tel: (509)688-0036 PERMIT FEE:
Fax: (509)688-0037
4400.WileY
permitcenter@spoka neva li ev.o rq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION In ADDITION/REMODEL ❑ ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: 2807 S. Wilbur Rd. Spokane Valley, Wa. 99206
ASSESSORS PARCEL NO.: 45284.1522 LEGAL DESCRIPTION:
BUILDING OWNER NAME: Donald H. &Joan I. Bliesner
NAME:Donald H. & Joan I. Bliesner
ADDRESS:2807 S. Wilbur Rd.
cm: Spokane Valley STATE: Wa. zip: 99206
PHONE:(509) 924-9323 FAX: CELL: (509)481-1835
CONTACT NAME: Donald H. & Joan I. Bliesner
PHONE: (509)924-9323 FAX: CELL: (509)481-1835
CONTRACTOR NAME: Donald H. & Joan I. Bliesner
MAILING ADDRESS: 2807 S. Wilbur Rd. Spokane Valley, Wa. 99206
cm: Spokane Valley STATE: Wa• ZIp: 99206
PHONE: (509)924-9323 Fax: CELL: (509)481-1835
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
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****YOU MUST COMPLETE THE FOLLOWIN6****-
MARK N/A IF NOT APPLICABLE
Height to Peale 14'_5.1 Dimensions:2.1.5'-16r No.of Stories:1 Total Habitable
Space:
Main Floor SQ FT:345.6 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: 1 Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ 15,000.00
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 may be required to be submitted and subsequently approved before this application can be processed.
Effective October 28,2007 Page 1 of 2
P:\Community Development\02 Administration\03 Forms-Offidal Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
Signature Date:
Method of payment: ❑ Cash ❑ Check ❑ Visa ❑ Mastercard
Bankcard #: EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc