2015, 01-13 Permit App: BLD-2015-0061 Addition Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Sp_Cry 09"\1254t,
Spokane Valley,WA 99206
Tel: (509) 720-5240 PERMIT FEE:
Valley® Fax: (509) 688-0037
permitcenterCcaspokaneva lley.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION ADDITION/REMODEL D ACCESSORY BUILDING
Q DECK [] OTHER
SITE ADDRESS: � ' et -4 • _
ASSESSORS PARCEL NO.: LEGAL DESCRI• •
RECEIVED
OWNER/APPLICANT (CHECK BOX,IF MAIN CONTACT n):
th Crt Cal.I VA, AN 13 nib v
J
ADDRESS: c U�>tiu��IT CENTER
CITY: STATE: ZIP:_�..., Ey '
SUB
PHONE: FAX: •---Emmt ---
CONTACT NAME:
PHONE: FAX: EMAIL:
CONTRACTOR NAME (CHECK BOX,IF MAIN CONTACT�: S2,1_ 4y7 147 / 7 0)71r. LLc,
MAILING ADDRESS: VO gOX 4g
CITY: 1 a) -r7 la k`L STATE: A ZIP: ' O lc?ff q Stew e R.
PHONE: 4-Oe? ] 7 q y FAX: sd g a cS 421/51 EMAIL: I i b ecty/4 Kle INQ•nLCOM
CONTRACTOR LICENSE No.: Sl.HAyKd,$7v KA EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
Aoki r 7\c-cc;O wa l I s 2 ba t'I•covin, i yt sr4 I( S >\r, rC i(-eZ t AE, Qat r r T S k 1/..34(/S
re) VeXtZecle.
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT T APPLICABLE
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 30%Slopes on
FT: Area: Property:
No. of Bedrooms: Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ I Q,0:3
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 requ re• to be submitted and subsequently approved before this application can be processed.
Signature � Date: 0312 o i5
Updated 12-1-14 Page 1 of 1
6 I 7) •
Project #_ I___2 1. _i J__2 0- I
RECEIVED
JAN I 3 2015 0
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