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2011, 10-05 Permit App: 11003149 Finish Bathroom
r Community Development Department Staff Use Only) Permit Center 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: '( -3,q9 QTY Spokane Valley,WA 99206I Tel: (509)688-0036 PERMIT FEE: !511 Y Van el 537, Fax: ( permitcenter©sooka509)688-0037nevallev.orq 40000 RESIDENTIAL CONSTRUCTION PERMIT APPLICATION E NEW CONSTRUCTION ADDITIONJREMODEL 0 ACCESSORY BUILDING DECK 0 OTHER SITE ADDRESS: I I G v S E. 'Znd AveL ASSESSORS PARCEL NO.: Lisa$L-j- (q'15 LEGAL DESCRIPTION: BUILDING OWNER NAME: J pt._ m' Chat-10-1-fie Lcc NAME: �l V 1 Lo�G (J ADDRESS: 11905 G , 3.)4-1`-G ✓ , ue_. Cm': S p okac h e. \)a I te,y STATE: .4114 ZIP: 96/(3206, Ccc .,' as(-S 3sv C s/ PHONE: rr 1�%� ' FAX: CELL' f S "k� 1 CONTACT NAME: C./11C4,1-1 6(12/ PHONE: 'c', 51. - 535-D FAX: r---._... CELL: ,)5 f - 5 3 CONTRACTOR NAME: MAILING ADDRESS: CITY: STATE: ZIP: t PHONE` FAX: CELL: - CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO..:: DESD USE: WeCRIBE gtf (A001 6 OPE Ob ireoirr) i r\ The b ORK IN,DETAIL D INDI-T YISiErY}Rbinq s Eck I('ea y i n -}'�1e •ioof. `&k i'1 '� -17? LLI�d 'he Goa�IS a r CAd 'X f 1 ****YOU MUST COMPLETE THE FOLLOWING**** MARK N/A IF NOT APPLICABLE Height to Peak: Dimensions: No.of Stories: I Total Habitable Space: go-C) Main Floor SQ FT:96,0 Upper Floor SQ FT:pprk Unfinished Basement SQ Finished Ba 7e Q 0 5 Garage SQ FT: �` C/Y1 Deck/Covlered Patio SQ Impervious Surface 30%Slopes on `7 go FT: : C)Q Area: /GM- Property: ✓.;f lf No.of Bedrooms: 3 Construction Type: cZahalei Heat Source:Cie, Sewer or Septic: SeLt}e2-(-- TOTAL COST OF PROJECT: $ LIi 000 of Forred Ar 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. Effective October 28, 2007 Page 1 of 2 P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doc . Signature C"1----Ii. Date: 0751/1 Method of payment: 0 Cash 0 Check 0 Visa 0 Mastercard Bankcard #: EXP: VIN#: Authorized Signature: Effective October 28, 2007 Page 2 of 2 P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Residential Construction Permit App 10.28.07.doc