2012, 08-16 Permit App: BLD-2012-1340 Residence r Project # `'ZOIZ-13
DECEIVED
Community Development Department (Staff Use Only)
Pe it Center
+ 11 03 East Sprague Avenue,Suite B-3 PERMIT NUMBER:
« 'I Sp kane Valley,WA 99206
•. Ai" Tel (509)688-0036
I-V '�— C'i TER Fa*: (509)688-0037 PERMIT FEE:
erimitcen er.s..kanevall- .or.
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION 8 ADDITION/REMODEL gm ACCESSORY BUILDING
DECK 8 OTHER
SITE ADDRESS: Kft2V.I, k IOP
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: 1,0 2W.
BUILDING OWNER NAME: PWN e
NAME: `/1 moi, L.,1.., tj.
ADDRESS: Do 4• stkirge ny �• 0 r—CITY: I • 4i1 STATE: 04. ZIP:. q"L fiV fC7
PHONE' 56-/ 12.# Mil / FAX( tt� -19 1�- CELL: _5-09 '5- 10,'Y
CONTACT NAME: D klai91J l 04
PHONE, _5-0q - .559- .7 97 3 FAX calteif+`-(9114 CELL/ 50 9 -16-64 - 7C,7
CONTRACTOR NAME: N- Ii 112 HO-7 L..G.
MAILING ADDRESS: alp j,, L R.Ng r11/4r PD•--# o
CITY: ��� STATE: (r ZIP: 19 260.
PHONE -h 7 1 i'(/ /Z-// FAX( 1)V2-0117 CELL( 2U7 -...69- -- 7%l 70
CONTRACTOR LICENSE NO.:1,14 LA,O$1J . EXPIRES:1.11.14
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF O KIN DETAIL AND INDICATE USE & PR POSED USE:
4 i P4L i, ‘,0 it6rno
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak II Dimensiooe:, j I No.of Stories: k Total Habitabpooth
>O' Space:
Main Floor SQ ,fh Upper Floor SQ FT: Unfurl B ent SQ Finished Basement SQ.
Garage SQ FT• Deck/CoveretPatio SQ Impervious Surface 30%Slopes on
`91 FT: I Area: Property:
No.ofBedroo` ms: ' Construction Type: 1400 p Heat Source: Q
4 .� ew Sor Septic:
TOTAL COST OF PROJECT: $ 75;OM `�
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 m. .:required toib,oeoe miffed and subsequently approved before this application can be processed.
Eff lye October 28,200 Page 1 of 2
P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc