2012, 11-21 Permit App: BLD-2012-2113 RemodelSpokane
,,;0o0;Valley-
Community Development Department
0ermit Center
1703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@sookanevallev.orcl project
(Staff Use Only)
ERMIT NIIMBER:
PERMIT FEE
RECEIVED
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION j
❑ NEW CONSTRUCTION Z ADDITION/ REMODEL ❑ ACCESSORY BUILDING
❑ DECK ❑ OTHER C V PERMIT CENTER
SITE ADDRESS: /� Ci �3 z-'. ;2��� 1 e�x .-,.-%%0'/ J
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
LEGAL D
9X,e Cd 7^W
NAME: �l �IlJ �!�x—�11�TD'r 4 U /✓/L 1 ` i Z"
ADDRESS: 7-j
CITY: �'9j)�f1,.i %z&Z�� STATE: ZIP:
PHONE: �� �g Y3 FAX: CELL:
CONTACT NAME:
HONE: FAX:
CELL:
CONTRACTOR NAME: 14 li(,�� l (cp =o�
MAILING ADDRESS: �ly . I 4�eG`41/
CITY::!S ha / /_ STATE: �j(��. ZIP: Q Q�d
PHONE:�y �4193 —&4- y FAX: CELL:
CONTRACTOR LICENSE No.AI VGzep(�oq EXPIRE /'� CITY BUSINESS LICENSE NO.:
CRIBE THE SCOPE OF WORTS IN DETAIL AND INDICATE USE & PROPOSED USE:
'ej r'!% /ll �/>Gi'b� .� . i //)i1�rt /�' /�G?/�y� /v 1-77,% X� I\
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT 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:
Area:
Property:
No. of Bedrooms:
Constr ction Type:
eat Source: I
Sewer or Septic:
TOTAL COST OF PROJECT:
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 requi5gd to be submitVd and subsequently approved before this application can be processed.
Signature L
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_-_Residential_1 l-11-1 l.doc