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2012, 04-16 Permit App: BLD-2012-0402 Pole Bldg
. Community Development Department (Staff Use Only) Permit Center 11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER: CITYSpokane Valley,WA 99206 ` ��/p Tel: (509)688-0036 PERMIT FEE: l ley permitcenterC�Fax: (509)688 0037 spokanevallev.orq RESIDENTIAL CONSTRUCTION PERMIT APPLICATION 111NE� DECK ❑ OTHER HCRUCTION IDADDITIO ADDITION/REMODEL ACCESSORY BUILDING r_ __.-_-. _ _ _ _ _ _ SITE ADDRESS: I L'WLe I- 1111"\-- I ASSESSORS PARCEL NO.: 45 2_2„..i, .0 7 lc( LEGAL DESCRIPTION::, BUILDING OWNER NAME: AFF'. ° off. � - • z_ `(o�. NAME: even 1 d l zo tiQ 311 yeiet-l -tilt 4 _ ADDRESS: regioco i- \ I , El,� CITY: SPDE' V)y -492] STATE: WA ZIP:t _ �4 PHONE: 509-G)35-300H f FAX: CELL: CONTACT NAME: D i G�n+� �A yeier PHONE: / FAX: CELL: CONTRACTOR NAME: Cd- i con, .4 pi J c +\0(\ ©� 5�� 2K�f�c MAILING ADDRESS: 5 -3 S "Bc s- � (I re - CITY: G re erGx c. r e 5 STATE: LA....* ZIP: 7,{``� `�/o i L PHONE:509 -0721c //%2 j-1 ` qQ 2 7 FAX: 509-92H-9027 CELL:5 �(}__/5 I -0 03 7 CONTRACTOR LICENSE No.: C3CoA4022SM EXPIRES: 7- 12- 12. CITY BUSINESS LICENSE NO.: DESCRIBE THE S OPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE: ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: Dimensions: . No.of Stories: Total Habitable to 94 4 Z(cPX 1 D � Space: Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ FT: Fr: Garage SQ FT: 0 14 Deck/Covered Patio SQ Impervious Surface 30%Slopes on qq L.) FT: Area: Property: No.of Bedrooms: Construction Type:`Poit. Heat Source: Sewer or Septic: TOTAL COST OF PROJECT: $ 1.i 2L 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. —. CD �, .- Effective October 28, 20 I Page 1 of 2 P:\Community Deve opment\02 Administration\03 Forms- Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doc -.12806 e 11th spokane,wa- Google Maps Nurti w Go sle i; Lt5223 01 I$ :. Q MC= Q g 9C11= Q MGM II a a � tr aiir NI http://maps.google.com/maps! 22 1(05 cP 1/ \'/ PLANNING DEPT. APPR® ED BY: ligr .........„ 3.,..111, .0--:-DATE: g116/� 1