2014, 07-31 Permit App: BLD-2014-1840 Residence , . 4
Community Development Department (Staff Use Only)
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11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Spokane Spokane Valley, WA 99206
�I�j Tel: (509) 688-0036 PERMIT FEE:
ValleY
K Fax: (509) 688-0037
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permitcenter@spokanevalley.orn
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION ADDITION/REMODEL 0 ACCESSORY BUILDING
0 DECK Q OTHER
SITE ADDRESS: 16614 E. 10TH LANE, SPOKANE VALLEY,WA 99037
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: 38 2 SHELLEY_ QKF_..._.--.-�---
-----
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BUILDING OWNER NAME: X 1 q --I Fo
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NAME:SAME AS CONTRACTORR , ?
ADDRESS:
JUL 312D14
CITY: STATE: ZIP:
PHONE: FAX: (yaii PERMIT CENTER
CONTACT NAME: v U B { _.__, R r 1�- `,. I _ i
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PHONE: FAX: w ._..
CONTRACTOR NAME:CAMDEN HOMES, INC.
MAILING ADDRESS: 15413 E.VALLEYWAY, C-300
CITY: SPOKANE VALLEY STATE: WA ZIP: 99037
PHONE: 509-252-9600 FAX: 509-252-9601 CELL:
CONTRACTOR LICENSE No.: CAMDEHI927JP EXPIRES:4/17/2014 CITY BUSINESS LICENSE NO.:602 818 471
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
NEW SINGLE FAMILY RESIDENTIAL BUILDING
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: No. of Stories: 1 Total Habitable 2 593
24' 76'x 72'-6" Space:
Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ FinishedBasementSQ
2,091 Bonus Room:502 FT: N/A FT:
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
1,538 FT: 332 Area: N/A Property: N/A
No.of Bedrooms: 3 Construction Type: NEW Heat Source: GAS Sewer or Septic: SEWER
TOTAL COST OF PROJECT: $320,000
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
Signature Date: -7-31-14
Method of payment: El Cash
1=1 Check El Visa 0 Mastercard
Bankcard # - 0 EXP:
Authorized Signaturej9 �G
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN G52014-030.
Effective October 28, 2007 Page 2 of 2
P:\Community Development\02 Administration\03 Forms Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc