2013, 12-04 Permit App: BLD-2013-2479 Repair Fire Damage (3c D --(--)v13p- c. 7.
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Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
cIT°Kane Spokane Valley, WA 99206
Tel: (509) 720-2540 PERMIT FEE:
Valley Fax: (509) 688-0037
permitcenter@sookanevalley.orq
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK 0 OTHER
SITE ADDRESS: /0361 ,E 9 '114, A✓C.
ASSESSORS PARCEL NO.: 45"20 4, O 452, LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: 5/4 f I Pl°p e "_ 1. L. _..
ADDRESS: ID 4 IO £ c +11 A✓c_ tt ,,
CITY: $/0k�WG All el STATE: f'✓4, ZIP: 11 Z D L.
PHONE:
FAX: CELL:
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: 81,,,ek 3 uIci ' r1,e T
MAILING ADDRESS: 3 6 S O h/, /&✓c4/ v-d 4v
CITY: /,J j` ///�/R'I 5 z STATE: _4c/frillt.) ZIp : t3 ._.5-4
PHONE: 2z6-- to& I— 6,4 3 / FAX: CELL:
CONTRACTOR LICENSE No.:(90,4-KSS- /-7/q d EXPIRES: CITY BUSINESS LICENSE NO.:tsoa-gsS-)9k/
DESCRIBTHE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
,v...L c., i)i. 4 j L is c)4, /(,
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No.of Stories: Total Habitable
Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ
FT: FT:
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
FT: Area: Property:
No. of Bedrooms: Construction Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ /C oc '
_ 613 x(07
DISCLAIMER Project # �---
The permitted verifies,acknowledges and agrees by their signature that: 1) if this perrr it is for constr fwir�ll ngrt�ie dwelling ll
be served by potable water. 2)Ownership of this City of Spokane Valley permit inure Ito the propert e i is the propentpe�sty
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the Citylof
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City lof
Spokane Valley permit is not a permit or approval for any violation of federal, state orl local laws, coded br ol-dlliatice20* Plan ad itiolal
Information may be"required to be submitted and subsequently approved before this application can be processed.
Signature 'j/r ^kG-Dal/ EER txe: /- ITT R .
I
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/2743/Res_Permit.doc
t Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
SCITYoF,rs� -- _ Spokane Valley, WA 99206
pokane Tel: (509) 688-0036 PERMIT FEE:
4000Valley Y Fax: (509) 688-0037
permitcenter@spokanevallev.orq
COMMERCIAL (NON-RESIDENTIAL) CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION E TENANT IMPROVEMENT OTHER
SITE ADDRESS: w,v..irm isii
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: _
BUILDING OWNER NAME: /`.r!. i'"r""'= "ILI,rimi�" — _r a _._Y-.. 77
•
MAILING ADDRESS: 6 KA,e- ( o((/7 -l - C E I V _
CITY: [PIP n V iiSTATE: ZIP: ifi
i
t� / La; k 2013
CONTACT PERSON NAME: �/
PHONE:
FAX: CSV P FP,' CPNTEn
1
CONTRACTOR NAME: 19)(116,e5 K(0 v , Si IR . I
w
MAILING ADDRESS: S �/O �1 V 1 J/l/< /
CITY:
af � STATE: I 17 ZIP:
(0fn4� b("i3FAX: CELL:
PHONE: vV�J� 6666
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
ARCHITECT/COMPANY NAME:
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE:
FAX: CELL:
NAME OF OCCUPANT OF STRUCTURE:
PHONE:
FAX: CELL:
CONTACT PERSON NAME:
PHONE:
FAX: CELL:
DESCRIBE TI-M SCOPE OF WORK I DETAIL
as ru,s565 dine roci< -- - re .'a�na,c�
TYPE OF PROJECT:
I TOTAL BUILDING SQ FT:
HEAT SOURCE: FIRE SPRINKLERS:
PRIMARY OCCUPANCY: SQ FOOTAGE:
SECONDARY OCCUPANCY: SQ FOOTAGE:
TOTAL COST OF PROJECT: $ '(0' 0 0
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 • / ��``�!Ai -\- Date: i 2. -AO`I 3
Updated 1-10-2011 Page 1 of 1