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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: Milian*wind Saler bed roam as bantam t6-F.iaoloyaY b.etl..Mi4 n0a b m0!AYL diming).Woe imam!elslsclaw *sada sd include.,d krOyer.wow so.ebatlOYu.Yd puntodhows and wall nrtli/rwM S 6i..Wawa renting Addition b adad anger bed coo and Wilma IV-F.Poor9siO a®waswsOM labor Waft(Rat..UJllese lenr0 abelitl.owb bcab and&slat.*.*dryer.awe Lower to Wake end Awe Ito Amer win s...oin.W2 draft.Do a ..wrong. ****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