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2012, 03-14 Permit App: BLD-2012-0151 Residence Community Development Department (Staff Use Only) Permit Center , I 11703 East Sprague Avenue, Suite 8-3 PERMIT NUMBER: I — Z --/ CITY OF Spokane Valley,WA 99206 Tel: (509)688-0036 PERMIT FEE: Fax: (509)688-0037 40 .\74-41ky` permitcenter©spokanevallev.orq RESIDENTIAL CONSTRUCTION PERMIT APPLICATION In NEW CONSTRUCTION El ADDITION/REMODEL ❑ ACCESSORY BUILDING ❑ DECK ❑ OTHER SITE ADDRESS: - $O @792 / 4 / t- /2, 14 F___-_ - —___ ASSESSORS PARCEL NO.: 4524.3411 LEGAL DESCRIPTIO :L 11 EF 1i 6 BUILDING OWNER NAME: j ')19 MAR �q ? i r' NAME: na;��}.�� r/ � I __-i SI _6 I '�,t ADDRESS: t ;-11110nn /V `i', _ cif; SPOKANE STATE: WA juur7llitP 99223 .J PHONE:509-568-1013 FAx: N/A CELL:509-879-3420 CONTACT NAME: PHONE: 509-568-1013 FAX: N/A CELL: 509-879-3420 / CONTRACTOR NAME: 4i11' c/ -€ 7t- MAILING ADDRESS: PO BOX 30792 Crrv: SPOKANE STATE: WA zip: 99223 PHONE: 509-568-1013 FAX: N/A CELL: 509-879-3420 CONTRACTOR LICENSE No.: LINDSC10660W EXPIRES: CITY BUSINESS LICENSE NO.: LINDSC1Q 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:23 Dimensions:60)(54 No.of Stories:1 Total Habitable 2972 Space: Main Floor2 FT:1486 Upper Floor T: U finis;e4Iriement SQ FinFinished Basement SQ Garage SQ FT• Deck/ overed Pat o SQ Impervious Surface 30%Slopes on 3� iJ FT: 233.75 20 Area: 2360 Property: No.of Bedrooms:3 Constru pe: Heat Source:NATURAL GAS Sewer or Septic:SEWER 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 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. Effective October 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