2014, 10-28 Permit App: BLD-2014-2641 Duplex Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Siliokane Spokane Valley, WA 99206
Tel: (509) 720-2540 PERMIT FEE:
T T���e�K Fax: (509) 688-0037
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RESIDENTIAL CONSTRUCTION PERMIT ARMLLtA''N1
NEW CONSTRUCTION 0 ADDITION/REMODEL 0 ACSEIS` tMILD
0 DECK 0 OTHER//
SITE ADDRESS: /27/2 -14 q // I
CSV PE` MIT CENTER
ASSESSORS PARCEL NO.: LEGL DESCRIPTIO k . � % - �,(�T y
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BUILDING OWNER NAME:
,3-1/ - P'Phi-J13 1 .. ,i -. .-
NAME: 1
PX Rfr5 1/114€6.5 1-Z- 6,-,-'
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ADDRESS: d / V 171 4 b'4 V 4 /
CITY: PDX171/„ STATE: /i 415, /�y/� ZIP: 7- '--
PHONE: FAX: /�C�EL✓L�:/ ���
CONTACT NAME: ��� P,/�� j' i,/' Afj 4 �iflt�i/l( BZ/, 7-
PHONE: FAX: CELL:
CONTRACTOR NAME: L� j j
MAILING ADDRESS: 5 a//(�/� ) 44ejy'� 11 rn` y5 C
CITY: ` ra STATE: d i���T71/ ZIP: 17Z //,,
PHONE: - t7( FAX: c-5L - Z 3 / CELL: 9 cl- 0 ,. �� `(!/7
CONTRACTOR LICENSE No.:PA / Z, MEXPIREs: /_g-2,a ITY 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: S / Dimenssn�:y,76 e�/- No. of Storie,: Total Habit�ble �a/-
?'T !�- �1 Space: `t 4
Main Floor SO FL.,
E Upper r SIFT: Unfinished Basement SQ Finished Basemen SQ
// Azti NFT: FT: AV 0 AA((
Garage SQ FT: Q Deck/Covered Patio SQ Impervious Surface 30%Slopes on
47 e"di FT: NO W Area: Property: iv 6
No. of Bedrooms: (acts Construction Type: W0 0O Heat Source:F Ark 6,4S Sewer or Septic: SPaVer-
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 approya or any violation of federal, state or local laws, codes or ordinances. 6) Plans or ad itional
information may be required to be sub it e d bsequently approved before this application can be processed.
Signature Date: // 71/
Updated 1-11-11 Page 1 of 1
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