2013, 12-19 Permit App: BLD-2013-2598 Foundation r
Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER:
S° °'Ikapne Spokane Valley,WA 99206
Tel: (509)688-0036 PERMIT FEE:
valley. Fax: (509)688-0037Dermitcenter onsookanevallev.orq
.40000
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RESIDENTIAL CONSTRUCTION PERMIT?-APPLICATION_ _:__,_ _
f NEW CONSTRUCTION j ADDITION/REMODEL ErACCESSORY BUILDING
Iffl DECK . OTHER ,N, ,a . °)------- --
SITE ADDRESS: (o // 2 ,.
ASSESSORS PARCEL NO.: ,,•7 ;1' ?1f/O LEGAL DESCRIPTION: s ',
BUILDING OWNER NAME: '
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NAME: 7711.1 t,,;t31-i1(r- —
ADDRESS: j _
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CITY:
STATE: Z .�__...... _..._,..
PHONE: /� FAX: CELL: •'
CONTACT NAME: 0-7 a/'r;-i)61 r.�" • • ((/„'7,i i ...7„) • . ••
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PHONE: ' :. FAX CELL: c/1, 3 /�/
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CONTRACTOR NAME: I 'P)e=,PY S'l� • th/IA e's..
• MAILINGADDRESS: .96•/6 �: i ov7 .15 v fr, ( 1- Q
Cm(: . l-�.I)/( r- ( . STATE: (,u ZIP:.: / 901 c 4
PHONE: FAX:
CELL:
•
CONTRACTOR LICENSE NO.: • EXPIRES: CIN BUSINESS LICENSE NO.:. •
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE &PROPOSED USE: •
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: DimensionNo.of Storie : Total Habitable 0
7Oi I r� / Space:
Main Floor SQ FT: Upper Floor T: Unfinished Basement SQ Finished Basergept SQ
$U G FT: �G O FT: ��`J'
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
FT: Area: Property: /e,.
No.of Bd rooms: Construction Type: S#c k Heat Source: 6 frS• we7r-br Septic:
TOTAL COST OF PROJECT: $ 41A11A4V co'&' a
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 submitte• - •subsequ y approved before this application can be processed.
Signature i' Date: /,V/10 i?/..3
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/fliestorage/124/938/210/948/1496/Buiiding_Permit =Residential_11-11-11.doc
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