2015, 05-15 Permit App: BLD-2015-1108 Plumbing Fixtures[iC[TY OF
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Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-5240
Fax: (509) 688-0037
perm itcenter@sookanevallev. orq
1"ERMIT 1\UM6ER: - ��_�
pokane PERMITJE:
Valleyk
C om','' � { v L C NTE R
RESIDENTIAL CONSTRUCTION PERM '�PPLI cThN
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❑ NEW CONSTRUCTION ;g1 ADDITION/REMODEL
❑ DECK ❑ OTHER
SITE ADDRESS: 7I/OGE D n`j/v& � „Spbko•Da. Wiq ''t .1a
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
❑ ACCESSORY BUILDING
OWNER/APPLICANT (CHECK BOX, IF MAIN CONTACT LYJI:
NAME: f e.:€1 1c\ / t ke ho,c&
ADDRESS: 7't 5 c2 // g
Cm: pc5k.zAine,V l id
PHONE: f 3 ?7 I 1
STATE: 0/11)
Fax:
CONTACT . NAME: �� �rj 1(J`t,,, (, wq,Nacy .. \ htu .
PHONE: ,Sb a� 1 •J . ?71
FAX:
ZIP:,�11,919
EMAIL: nc^L . AIM -AC QtriA eorn
CONTRACTOR NAME (CHECK BOX, IF MAIN CONTACT ❑):
EMAIL:%l 13 AVE
MAILING ADDRESS:
CITY:
PHONE:
CONTRACTORLICENSE No.:
EXPIRES:
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
L61•1.2- I t om% (te t fa 9G � )/ V S�`w� I bi{et)? V�/t�ihcfo W , Fne es.�
One MM' 471.e>6 or;.c (coil .e4-1--�v (,L 77/e �.Stietv�>' air- (fib ,s pre netl-10
11-rlitLe X11 Ute^* * YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABL
Height to Peak:
'q
Dimensions: %3ect�ro
fort•r
WO" "A N43"
No. of Stories:
1
Total Habitab a
Space: I043��
Main Floor SQ FT:
/OA
Upper Flo9r SQ FT:
A -A
Unfinished Basement SQ
Fr: •c VA
Finished Basement SQ
FT: .0/4
Garage SQ FT:
A.j m
Deck/Covered Patio SQ
FT: .X.-3/4
Impervious Surface
Area: 43��
30% Slopes on
Property: x.)/4
No. of Bedrooms: Q.
Construction Type:
Heat Source: EreG Free
ewelrbr Septic:
TOTAL COST OF PROJECT: $ 1,w)e)
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.
Signature
Date: S/rq//c_C—