2015, 02-23 Permit App: BLD-2015-0320 Roof Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
SCITY Spokane Valley, WA 99206
okane Tel: (509) 720-2540 PERMIT FEE:
Valley. Fax: 688-0037
permitcenitcenter@sgokanevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
Q NEW CONSTRUCTION ADDITION/REMODEL , [ ACCESSORY BUILDING
Q DECKOTHERRR�JL��/�,t�
SITE ADDRESS: /52/O £ / 1 ///
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: GLCLl j 4z
NAME: /-7„Gf /h-7 il
ADDRESS: /5-0/0 a /8'
CITY: s, e). . U4'4 STATE: U4- ZIP: `�' u3 7
PHONE: pj /l.-- q 5 U Z_. / FAX: CELL: j'7;j-&/'
CONTACT NAME:
.-.--__
PHONE: FAX: C LL.
CONTRACTOR NAME:
F CEIVED ,(2.1--)
MAILING ADDRESS: !`E.B ? 4-2015
P:R
CITY: STATE: ZI
t� PFf�,111 i_;!-N 1 (_r
CONTRACTOR LICENSE No.: EXPIRES: CITU 4USJ.NES3lICELSE — ✓ --_
PHONE: FAX: U CELL: _ _
lV0
DESCRIBE THE SCOPE` OF WORK IN DETAILANP INDI ATE USE & PROPOSED USE:
GOve,c/ fi�r.se� //iZv/7/;5 d.? �J S<<cr/c°' p t' —i- -
****YOU MUST COMPLETE THE FOLLOWING****
MARK N_/A_ IF NOT APPLICABLE
Height to Peak: Dimensions, No. of Stories: Total Habitable
/3 " 2 7'/ /0 'C '' A)/11- Space: /t-
Main/For SQ FT: Upper Floor SQ FT: Unfinished Base nt SQ Finished Basement SQ
�/ //4FT: 4-1 4 FT: A-1/11-
Garage
v/Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
AV/i FT: z v s5, _ , Area: Property:
Nle
No. of Bedrooms: ,J j4 Construction Type:: <,-e) Heat Source: Sewer or Septic: ,L.)/4.
TOTAL COST OF PROJECT: $ /3 40. 06
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 requir d to be sub Itted and subsequently approved before this application can be processed.
Signature / Date: 2/Z3/Z6-)/.5–
Updated 1-11-11 Page 1 of 1
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