2013, 06-04 Permit App: BLD-2013-1030 Remodelsm,.kan
Po
40•0011ValleY
Community Development D
Permit Center
11703 East Sprague Avenue
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
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Project # R..'3—J p30
RECEIVED
partment (Staff Use Only)
! y�l v
Suite B-3 PERMIT MBER:
CSV 1E$IT!!NTER
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION Et ADDITION/REMODEL 0 ACCESSORY BUILDING
WA
0 DECK 6 D�� 0 OTHER
SITE ADDRESS: 1 LI g 1 o E ?4 S po\cca"e. Va`\ ty
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: Elk ;0-k; W caN, mc-\`
NAME: £ 1h- ok LI 4,..A AGAN,
ADDRESS: 1 4-) If 1 0 £ al 9+1%
CITY: 5 P n'c a.., e V Cl &.`/
(IR o3
gSTATE: ZIP' a037
PHONE:sO - 3 1 3- 0 1 10 FAX: CELL: ,r01 0( 5 .s `‘R°00
�t1
CONTACT NAME: C. I (; it- (k`l 0.L
PHONE: S (2° - 32,3 -
O \\ 0 FAX: CELL: 5 O 0.- NS 3- r0 O
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
CONTRACTOR LICENSE No.:
DESCRIBE THF SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
FAX:
CELL:
EXPIRES: CITY BUSINESS LICENSE NO.:
Re -n-10(44 r
Height to Peak:
Main Floor SQ FT:
a\O0
Garage SQ FT:
No. of Bedrooms:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Dimensions:
Upper Floor SQ FT:
Deck/Covered Patio SQ
FT:
Construction Type:
TOTAL COST OF PROJECT: $
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
DISCLAIMER
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
Spokane has permission to Valley Developmentpresent the code. Referenced codes are roperty owner in ava available for review aAll
t theconstruction
C City of Spokanedone
Val Valley Permit Center. 5)with
The City of
papproval for anyviolation of federal,state or local laws, codes or ordinances. 6) Plans or additional
Spokane Valley be required not to permit b or
information may be be s�b�itteand subsequently approved befor/e this application can be processed.
6 ( ( I o Page 1 of 2
Effective OL• er 28, 2007
P:\Community Development\02 Administration\03 Forms100 Official tloecrsions\Permit Center\Residential Construction Permit
. , 000
No. of Stories:
Unfinished Basement SQ
FT:
Impervious Surface
Area:
Heat Source: 0 -(AS
Total Habitable
Space: 1/0 o 0
Finished Basement SQ
FT: / Cl 6 O
30% Slopes on
Property:
Sewer or Septic: