2013, 04-04 Permit App: BLD-2013-0575 Addition Proj 'C # (8d-1 3—cic
RECEIVED
Community Development Department (Staff Use Only)
Permter
11703 EastCeSprague
Raab
2013
ITV OF,�� 11703 Sprague Avenue,Suite B-3 PERMIT (jaB�it
Spokane Valley,WA 99206
Tel: (509) 688-0036 pL n 15efl Mi T CENTER
Fax: (509) 688-0037
permitcenter@ sookanevalley.orq
.000valle .
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
❑ NEW CONSTRUCTION ADDITION/REMODEL 76 ACCESSORY BUILDING
�] DECK El OTHER
SITE ADDRESS: J 6-6 2O E /�" AVE,
ASSESSORS PARCEL NO.: R LEGAL DESCRIPTION:
BUILDING OWNER
/� IR NAME: Df3ERT L < L EE
NAME: h.013 E „ Lee-
ADDRESS: /S& W E . /9--'AVE.
'/
CITY: �/ C-g L 4L e- STATE: (/'IX% ZIP: 9 703 7
PHONE: 2(0 2 4300 y— FAX: CELL:
CONTACT NAME: /Q D1&Q 1
PHONE: FJ cl3 O FAX: CELL:
CONTRACTOR NAME: S A N?
MAILING ADDRESS: S,/I7ET AS , 1J?Vz
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NQT APPLICABLE
Height to Peak: Dimensions: No. of Stories: 6/ Total Habitable/> j�`_
Space: (G�
Main Floor SQ Fr: Upper Floor SQ FT: Unfini hed Basement SQ ' Finished Basement SQ
��9� FT: ( FT: 0
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
FT: Area: Property:
No.of Bedrooms: / Construction Type: Heat Source: (Sewer>Septic:
TOTAL COST OF PROJECT: $ 2 0 000, o°
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 tto�beesubmitted and subsequently approved before this application can be processed.14/
Signature %2�i,�.r�•D c— . , 25� Date: 2 /3
BD-02 V-1 Page 1 of 2
Method of payment: ❑ Cash ❑ Check ❑ Visa ❑ Mastercard
Bankcard #: EXP: VIN#:
Authorized Signature:
BD-02 V-1 Page 2 of 2