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2013, 07-12 Permit App: BLD-2013-1376 Deck Community Development Department (Staff Use Only) Permit Center 11703 East Sprague Avenue,Suite 8-3 PERMIT NUMBER: SiTiA ^ Spokane Valley,WA 99206 ; �ji,( 17 Tel: (509)688-0036 PERMIT FEE: ValkTFax: (509)688-0037 permitcenterOspokanevalley.orq 0 RESIDENTIAL CONSTRUCTION PERMIT APPLICATION il:1EW CONSTRUCTION In ADDITION/REMODEL Q ACCESSORY BUILDING In DECK ig. OTHER SITE ADDRESS: /4.2, /5 1 M�$v-e_...., ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: • BUILDING OWNER NAME: • NAME: 6////[//t' ' b� ��a v f ADDRESS: / (�� / /1 fe CITY:S/9 i° V d//tom STATE: �/��ill ZIP: q� PHONE: �5L)g- 771/- oz /'� FAX: CELL: CONTACT NAME: /l��(-) Dgtir S PHONE: 7/1/ /a _ FAX: CELL: CONTRACTOR NAME: /-j/ // Da/( a S MAILING ADDRESS. C' Z`j Ai. 5,. y , l t1 i CITY: .5 nt�✓�/k 4 n _ STATE: (,✓I t ZIP: g, Z,0(aj PHONE: 460"t C-(L & 1161- FAX: (Sl(V -3 114 Zj CELL: 576 qt,31 /� CONTRACTOR LICENSE NO.: (')MJ. k Ck q(t P 3 EXPIRES: It' ' i 3 CITY BUSINESS LICENSE NO.: ' 120 5 -i C 13 4 5 DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE: ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF N-OT APPLICABLE Height to Peak: Dimensions: No.of Stories: Total Habitable Space: Main Floor SQ FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement SQ FT: FT: Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on FT: I C\ L? Area: Property: No.of Bedrooms: Construction Type: Heat Source: Sewer or Septic: TOTAL COST OF PROJECT: $ L)zci3 ,CC 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/wilt 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. SignatureA&1)dads..//, Date: L/��/7 Updated 1-11-11 Page 1 of 1 http://www.spokanevailey.org/filestorage/124/938/210/948/1496/Building_Permit -_Residential_11-11-11.doc PLANNING DEPT. APPROVED BY: d C /r - i .c.---, . : 4, xe_d DATE: -1L7 /za/3 4 1 V J V 7 r 1 `V m • \V . V 1