2014, 10-20 Permit App: BLD-2014-2565 Duplex rniart .tab • 1'.25v 5
Community Development DepartmentFilreacetviEvp) al.
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:SOlikine Spokane Valley, WA 99206 in- 2 0 2 �4
Tel: (509) 720-2540 PERMIT �'
Valley4.jFax: (509) 688-0037
permitcenter(aspokanevallev.org CSV PERMIT CENTER
SUB # / REV. #
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
ki NEW CONSTRUCTION Q ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: /S-.71Z i -7,01
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: 1Cric
NAME: Oa'vl 49G.i r/'—/
5
ADDRESS: / 22/ t(741 /
CITY: frC'rofzA STATE: I /9 ZIP: /5Sa 37
PHONE: �O j O L 3 - 372 3 FAX: j v 7 51 7—x/67/ CELL: O+6 .3 - 1723
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: 6#y e �o 4,,e,.1
MAILING ADDRESS: /
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: cc dot.,,C/(C 'E006 ,,XPIREs: /,./6 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
A/eAi c iJN_f/rt. e,zed:i Q/./.0),x
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No. of Stories: / Total Habitable
3-7 X Y! Space: .7 l6
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
/732 X,Ar9 FT: //2 , 73— FT: /r Y 5-
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30% Slopes on
Cf
FT: /1'2 Area: Property: O
No. of Bedrooms: u" Construction Type: w 0.I Heat Source: 'di
f t .r Septic:
TOTAL COST OF PROJECT: $
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 4‘..:—/ , Date: /e 2 a / y
Updated 1-11-11 Page 1 of 1
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