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2012, 10-29 Permit App: FAS-2012-0009 MH p34-s - zo/Z - a©a9 . • Community Development Department (Staff Use Only) Permit Center 11703 East Sprague Avenue, Suite 8-3 PERMIT NUMBER: So1►Ile Spokane Valley, WA 99206 p ■r! Jrjj Tel: (509) 688-0036 PERMIT FEE: , lleT Fax: itcen 88 0037 400100 pax: (5 9) 6 68 spokanevallev.orq RESIDENTIAL CONSTRUCTION PERMIT APPLICATION ❑ NEW CONSTRUCTION ❑ ADDITION/REMODEL ❑ ACCESSORY BUILDING 0 DECK 0 OTHER SITE ADDRESS: /I ASSESSORS PARCEL NO.: 55192.1312 LEGAL DESCRIPTION:/9/9,41': V4Z-Z ., /42%f BUILDING OWNER NAME: /77-A-5-1-d2,-) 1"/2 '32. NAME: /174 -4/ / /�/(-5G/-•• ADDRESS: / 703 , • 427/ j1-70-- CITY: ()p` �i , ) /e t' 2// 7 STATE: i-Y' 4 ZIP: �50/�p PHONE: ! %L 6 - 7''1 6 0 FAX: CELL: 7p/ - 3 / CONTACT NAME: 4,. cAn/`j/�j-7 PHONE: FAX: CELL: cF .? — 7'9 33 CONTRACTOR NAME: /cL 77o6:":6-.le-,1./b/ 1.1 GiC MAILING ADDRESS: .'LL05' /-1/ 1i9.-/71 z//7' 1^/ CITY: Ag.A STATE: �/, ZIP: / ,d z% PHONE: 92? '22-O FAX:, /i � CELL: CONTRACTOR LICENSE No.: i/kf'/1)//j1/� .,E PIRES: //d2J CITY BUSINESS LICENSE NO.: ///e 45.7.5-- 0-I.) DESCgiBE nig S OPE OF WORK DETAIL AND INDICATE USE & PROPOSED USE: ac`s s,-,9/1/9 2i rJ /p-/:. i=7 /-- l�0lNi✓c A62 />r✓s,�=,c% 0/- ..3?:/ - /=//.r,,/✓' /74?,✓ //G 74 i4 f . 6 "195/71 ?ra!'C'j S. . ****YOU MUST COMPLETE THE FOLLOWING**** MARK N(A IF NOT APPLICABLE Height to PO( Dimensions: No. of Stories: Total Habitable j� Z� �� Space: f%`SL Main Floor SQ FT: Upper Floq FT: finished B , Hent SQ Finished Basem�efi5 SQ //cSL n// FT: //�j`` FT: ����// Garage SQ FT: Deck/Cov red atio SQ Impervious S reface 30%Slopes on 7 FT: i 14 Area: Property: No. of Bedro s:2 Construction Type: Heat Source. n/,4 Sewer or Septic: /✓A TOTAL COST OF PROJECT: $ /,3 oD, 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. Effective October 28, 2007 Page 1 of 2 P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doc