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2014, 10-28 Permit App: BLD-2014-2638 Duplex Community Development Department (Staff Use Only) Perm�� iter 11703 asCetSpr 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: Spokane Spokane Valley, WA 99206 Tel: (509) 720-2540 PERMIT FEE: Valle40000 Fax: (509) 688-0037 R permitcenterCalsookanevallev.orqrr � ]g Project / � is / RECEIVED RESIDENTIAL CONSTRUCTION PERMIT APPLICATION NEW CONSTRUCTION 0ADDITION/REMODEL 0 ACCES�ORY BUILDING DECK 0 OTHER I CSV PERMIT CENTER SITE ADDRESS: / 270 ii -- /0 9t 7 ��R ASSESSORS PARCEL NO.: LEGAL DESCI,�tAIrTId'4: C .WPA:1 BUILDING OWNER NAME: Sho/"� /A-� sl 0-/—/ .W 9 -ADDRNAME: a /9R,5 #1711 E.5 L Z.— 61,-- ADDRESS: ESS: d 1 V h 4 UA V A �j CITY: �o wee STATE: /I/7 // ZIP: ' 4*y","4.2-' — PHONE: FAX: CELL: CONTACT NAME: 47/i;e" /91V3* � hll/ /,/ 0g/t45M 7— PHONE: FAX: CELL: CONTRACTOR NAME: �j�/� / MAILING ADDRESS: 3 4//! ) ' . J4-u LL L.e C CITY: '-':-.;;;P‘) STATE: 6' ZIP: ` .Z.4 , ----- PHONE: , ..-.C. FAX: 7„�.341^'7 L- i CELL: 5-1`kie ff///e, CONTRACTOR LICENSE NO.:PA- #4. 6 EXPIRES: /—g-2t 7/ c TY 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/6 , Dimensions: 7 ev / No. of Stories:, Total Space:Habitable �� Main Floor SQ FT: / Upper kl $QQQ : G(iJ Unfinished Basement SQ Finished Bas moment SQ /4/ �l ew-ki /V �t( FT: /�l7/l' FT: D/S � Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on 47 g ,PSG 61 FT: No v , Area: Property: /i(©'re No. of Bedrooms: Construction Type:/i# 1 Heat Source:/ k/g evt--5 Sewer or Septic: '(ever TOTAL COST OF PROJECT: $ 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' or any violation of federal, state or local laws, codes or ordinances. 6) Plans or acyitional information may be required to be sub it e d bsequently approved before this application can be processed. /' Signature if Date: 4, Updated 1-11-11 Page 1 of 1 \\server0\users\mwagenblast\My Documents\Downloads\Res_Permit.doc