2012, 03-22 Permit App: BLD-2012-0213 Addition, Remodel i r t
e
Community Development Department (Staff Use Only) '
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
San'O Spokane Valley, WA 99206
PU i► .Ile Tel: (509) 688-0036 PERMIT FEE:
.0.00Vlley Fax: (509) 688-0037
permitcenterCulspokanevallev.orcl
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION ); ADDITION/REMODEL ❑' ACCESSORY BUILDING
❑; DECK (( ❑' OTHER / ,/�/ / c�
SITE ADDRESS: //9/7 Z� (l"' /VC .S'4/o/�1( U/�<<£'f/ Ai/V. !27�
ASSESSORS PARCEL NO.: '/$'�j/, /30`f 'LEGAL DESCRIPTION: '<JfjQ1.1'T&Ni/C .4lt,--. '/70 )
BUILDING OWNER NAME:
I,,/j/16e/STY✓ t./L/G'fj ep eA1-2414�� r eXC Af_r/o F e
NAME: AJ/ , ,'O /i'
'
ADDRESS: ///� 913 G ±4 c-
CITY: SAHA IU� dia(. L j STATE: ( /N- ZIP: 992 O1
PHONE: /FAX: CELL:
CONTACT NAME: ,le W /4 !
PHONE: S2? 36J-D�� FAX3d /L,ce CELL: c2 PAP— 727
CONTRACTOR NAME: (�€( /(�7[ ///J ec(c')A,f5% G e--7,- ,
MAILING
(ADDRESS:
/J ( /1/44,0 C (�
CITY: SA C' //Mg(, STATE:
�c 6J 4 �] ZIP: 9 7 20
PHONE: ,S9 f.5 e -//Dv FAX: ,C11P $327/ CELL: S61 7 2P9-v9...2/
CONTRACTOR LICENSE NO.:(MCDfi9Ci3/i/ EXPIRES: /.-- --/y CITY BUSINESS LICENSE NG-: a
DESC! E THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PR( POSEDIJ
1y" ,2 S/Oie l /tga=YZ2 ) / leintC re.. 1
****YOU MUST COMPLETE THE FOLLOWING**** "' 1(CJ IL-2_ 13
MARK N/A IF NOT APPLICABLE .Nam:,
Height to Peak: i Dimensions: . No. of Stories:2 hl t
g ,�„ !Total Habit�hle
Main Floor SQ FT: Upper Floor SQ FI: _ Unfinished Basement SQ Finished. S
i 3, 1 FX:„
d.BQ
. FT: 0.�T FT: - 10 I.
Garage SQ T: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
j/1 FT: Area: .8Property: AbAlc '
No.of Bedrooms: .2 Construction Type:1Jcr'3 Heat Source: cc-terSewer or Septic:gf.L`t
TOTAL COST OF PROJECT: $ (F)6 `. U
/
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 submi -:.and subsequently approved before this application can be processed.
Aide Ail -2P-7A
Effects•_ o ober 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
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Describe the scope of work in detail: Cost of Project: $ tr-- ' 7c-2Q-3
i
Proposed Use: i..--i,< /9._,)0 e'--r.6,,i
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT XS) PEAK: DIWNSIONS: #OF STORIES: TOTAL HABITABLE SPACE:
MAIN FLOOR 10Co5.,Qt L —
2 D FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG. ,-- ,
, Revvto°eic-• '' AREA:-4/4DOrAi592- Aocw-Po,, 'e, EX1,577/vCs
FINISHED BAS .
yrENT GARAGE SQ. FTG: DEC OV. pg10. Q. FTG: 30%SLOPES ON
SQ. FTG: ti A/k. / 5V : 7"
#0/ (0 et-) PROPERTY:
#OF BETOO S. • CONSTRUCTION TYPE: HEA • - -: SEWER OR SEPTIC?
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