2013, 01-15 Permit App: BLD-2013-0058 Residence mmunity Development Department (Staff Use Only)
mit Center
F 03 East Sprague Avenue, Suite B-3 �RMIT NUMBER:
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CITY Opokane
Spokane Valley, WA 99206
Tel: (509) 688-0036 i— 'ERMIT FEE - - v
Fax: (509) 688-0037
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RESIDENTIAL CONSTRUCTION PERMIT APPLUCAT ON
® NEW CONSTRUCTION ❑ ADDITION/REMODEL ❑ ICg . ; Fi7
❑ DECK ❑ OTHER
SITE ADDRESS: D m
� l N. SQA eac,IC kb. 5 U g i _- -.-- _,,--
ASSESSORS PARCEL NO.: 45131, 2'D1 LEGAL DESCR p-kT-131 7-~- ._...,._.e_...—.__
BUILDING OWNER NAME:
NAME: n1;4 TTi "aO&) Coms+2o ..1104 1.-1..c-
ADDRESS:
LC-
ADDRESS: RD, &1X, I 0 to 0
CITY: 04-is. O/2.4t444% STATE: -(�f/I - . ZIp: '79OZp7
PHONE: S09., 72-3 se 73 FAX: cc'9zi I " -22, ,�i CELL: 09-773- C�ca73
CONTACT NAME: ...)I m J/Y)0-4-�s.0�!
PHONE: -5C�4-773 - se 7 3 FAX: 5o9- et27 - Z29I CELL: 50 9- 7z3 - 9873
CONTRACTOR NAME: fl 14 - ,0i} CORS4-444)12111 C . 4.1-..C--
MAILING ADDRESS: ROI BAS- iOb O
CITY: o4-‘s QKt.14/..,t_4 , STATE: twiela4 ZIP:• 990 7
PHONE: Tag"' 7 Z 3- es 73 FAX: "S 0 i 97,7 j 291 CELL: "SQT IZ,'i eii 6 3
CONTRACTOR LICENSE No.: M 4t,EC),g4 itis EXPIRES: 3-I 9 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
/J.€42J S r--r_.
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: 2 9 i Dimegsions• No. of Stories: Total Habitable
3 ?� JAL rt40 Space: /9ga
Main Floor S FT: Upper Floor SO FT: Unfinished Basement SQ Finished Basement SQ
_ I ZO 9 '71 5 FT: .— .!!9- - FT: -e—
Garage
Garage SQ FT: • Deck/Covered Patio SQ Impervious Surrace 30%Slopes on
1 too FT:'7 s LA q a co Area: to 4 2 8 Property:
No. of Bedrooms: 3 Construction Type: AietJ Heat Source: G-'4-'S Sewer or Septic:Se Wet.
TOTAL COST OF PROJECT: $ /40 iD 00
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 ,. 6,4,47r4,-, Date: 13
)1014
Updated 1-11-1 Page 1 of 1
http://www.spoka neva Iley.org/fi lestorage/124/938/210/948/1496/Building_Permit_-_Residential_11-11-11.doc
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