2014, 04-29 Permit App: BLD-2014-0691 Patio Roof 1 Community Development Department (Staff Use Only)
✓ Permit Center
11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER:
SiiO14s
neSpokane Valley,WA 99206
a Tel: (509) 688-0036 PERMIT FEE:
W Fax: 688-0037 -�
�/ permItcenitcenter@spoka>1Qvallev.ora protect # i co '
RECEIVED
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
III NEW CONSTRUCTION ADDITION/REMODEL ACE SOZRAIILDING
11 DECK Wood I OTH R CSV PERMIT CENTER
SITE ADDRESS: g 0 Li 1c L 3 Ilk- .
ASSESSORS PARCEL NO.: LEGAL_DVf,�SCIRIP 6 V. ~ r
BUILDING OWNER NAME: Jck.1/\, l U t
NAME: 00 1/1., A- ` -'1s.) b 1 -e-A- :r
. ADDRESS: g0 /l �`� D ccL, 1.. 1/1_,-v .
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_...'...STATE: _ a1 ZIp; ° 9•o. 1. 6
PHONE: E9 - C 6I FAX CELL:
CONTACT NAME:
•
PHONE: FAX: CELL: •
CONTRACTOR NAME: I' , Q., \/ f)11` ft 4
MAILING ADDRESS: 1 ).11 a. co ifil(� O .
CITY:( D ka, 1 Ye. STATE:
PHoNE: (0� 8 —�}- `�n!' !(JgII, AX.7-->V ~ `A,8—/7S7 au:
if
GONTRA VIE 1a0:" 1" `P P. E EXPIRES: ( 3 5 1J 4rrY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWXNG****
MARK N/A IF JMOMETLICA,13LE
Height to Peak: Dimensions: No, of Stories: Total Habitable
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 3D%Slopes on
FT: Area:
Property:
No. of Bedrooms: Construction Type: - Heat Source: Sewer or Septic: _
TOTAL COST OF PROJECT: $
DISCLAIMEl1;,
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. .)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 Vsih y permit Is not a permIt or approval for any violation of federal, stag or local laws, codes or ordinances. 6) Plans or additional
Information may be uired to be submitted and subsequ:ntly appy ved before this appllcaHon can be processed.
/
Signature /, /. .��11 Date: 402.054
Updated 1.-11-11
Page 1 of 1
http://www.spokanevaliey.Org/filestorage/124/9380.10/948/1496/Building_Permit _Residentlal_11-11.11.doc
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