2013, 06-04 Permit App: BLD-2013-1033 Remodel ShopProject # u`ef - - 1433
Community Development Department
Permit Center %t ° 1 ty
11703 East Sprague Avenue, Suite B-3 " - "PEariVO31UMBER:
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037 1
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RE EEVED
(Staff Use Only)
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 ACCESSORY BUILDING
0 !, NEW CONSTRUCTION ►:.'�. ADDITION/REMODEL
0 DECK pdt,E3 OTHER
SITE ADDRESS: I M S I D £? L1 S po\cave. lea.\\ty
LEGAL DESCRIPTION:
ASSESSORS PARCEL NO.:
WA
ala 03?
BUILDING OWNER NAME: ;o* w ca\ wcNN
NAME:
ADDRESS:
CITY:
PHONE:
(I , 0'1- L) al\ack
Sp nl«ne valley
Soy -132,3 - 0110 0 C..
CONTACT NAME: I (, 6jf `✓ 0.�� 0.L(
STATE:
FAX:
CELL:
ZIP: \ 03 7
sn.k °l5S «&o6
PHONE: S 90 3a,3 - O‘\ O Fax:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
PHONE:
CELL: 5 0 4 • NS 3 - ?DO
STATE:
ZIP:
FAX:
CELL:
CONTRACTOR LICENSE No.:
EXPIRES:
CITY BUSINESS LICENSE NO.:
DESCRIB THE S OPEOF WORK N DETAIL S�
INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space: 4/000
Main Floor 1QQ0 FT:
Garage SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
Finished Basement SQ
FT: / GY, b O
30% Slopes on
Property:
No. of Bedrooms:
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 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 sulmitted and subsequently approved before this application can be processed.
Heat Source: (rus
Sewer or Septic:
6/ ! 8.0/3
Page 1 of 2
Effective October 28, 2007
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc