2013, 10-18 Permit App: BLD-2013-2157 Deck •
Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER:
San'r Spokane Valley,WA 99206
ol�ane014#141444Tel: (509)688-0036 PERMIT FEE:
Valley D Fax: itcen 688-0037
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RESIDENTIAL CONSTRUCTION PERMIT APPLICATION=
f NEW CONSTRUCTION K ADDITION/REMODEL El ACCESSORY BUILDING
NI DECK iffi OTHER
SITE ADDRESS: r
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: •
"NAME: I,a V t. //cis AA
ADDRESS: // /i/ I 'La , .
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CITY: pt. 4G V,-a,/ STATE: W�1�.• ZIP: 771--C‘
PHONE: y
e. O6 . ,904-7 FAX: fs,in t CELL:
CONTACT NAME: ' '
•
PHONE: c^,/As, • ;, FAX: CELL: '
(CONTRACTOR NAME: .
MAILING ADDRESS: y`/8j,..w° :5'A
�^ STATE: VA.• ZIP:.. riZGi�
CITY: . 'oh n h•a, { 9 ?
PHONE: 01 714" - FAX: / I&ei CELL: 3.o�`�O
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCORK IN DETAIL AND INDICATE USE &PROPOSED USE:
****YOU MUST COMP TE THE FOLLOWING****
MARK N A I NOT APPLICABLE
Height to Peak: Dimensions: No.of Stories: Total Habitable
Main Floor SQ FT: Upper Floor SQ FT Unfinished Basement SQ Finished Basement SQ
Garage SQ FT: Deck/Covere atio SQ Impervious Surface 300/0 Slopes on
FT: Area: Property:
No.of Bedrooms: Constr tion Type: Heat Source: Sewer or Septic:
TOTAL COST OF PROJECT: $ " y/ $ . C-0
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 to be submitted and subsequently approved before this application can be processed.
Signature ,%45/1,114Date: lam-//0
Updated 1-11-11 Page 1 of 1
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