2012, 03-29 Permit App: BLD-2012-0254 Residence cx
Permit Centel,
�, e 11707 E Sprague Ave, Suite 106 PEl2]VLIT N(7M13E R
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7 1 Spokane Valley,WA 99206 P R 11 SEE
V (509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.org.corn
Residential Construction r*New Construction ❑ Accessory Bldg
Permit Application o Addition/Remodel o Deck
o Other:
SITE ADDRESS 10 7 2 2 £_ 3�t
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: Lot LO 61k 2 Po✓tLkr SQ East-
,
AFAMA se 1 E 1114�r'�: I , 4 x La -� ' iaf . MANIA$ ... s V5i'
r..«� ..� .�.. ». �.-�I� s�-�'�.�.��s � �-� �.e...:�. 4 � =� l's,:._�.��+_�. oma.; s„,rw, pp�� �.���'. � .'z. .�,'. a �
Name: P i a yn �C C Cbvt 5 t. Name: b i A Moyle! �.oC K Ci S t,
Address: Address: Z(002 /V, S u I t i e it d
City: Zip: City: Spora,AQ- )a key Zip: 99 Zl k
Phone: Fax: Phone: 9 Z'- ' 6,4 Fax: 9 Z 6 - to 9 y
Lic No: .Exp.Date:
„,,,,,,,,,,,....,„...-4,.-..--,..to . �e . mrpp0,- �7, _ ,�., , City Business Lic No:
Name: PaiA t. Cc-o
Phone: Z l`6-yci. z'(
Describe the scope of work in detail: Cost of Project: $ 75, 000
Liu ck A V._l S F(t
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK: Z I, DIMENSIONS:�l xk a t• #OF STORIES: ! TOTAL HABITABLE SPACE:
ito 1566
MAIN FLOOR TO SQ. 2Nu FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG: 'S Nif� AREA: N/Pt-
15 Gro
FINISHED BASEMENT ' GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: 30% SLOPES ON
SQ. FTG: 0 'Iz i PROPERTY: /0/4
#OF BEDROOMS: 3 CONSTRUCTION TYPE: HEAT SOURCE: SEWER OR SEPTIC?
i,.kv)P Pr*rAt Alaiv,ra( 6c-s Fvr,na ce Set,"--r
DISCLAIMER
The permitee verifies,acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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 VuS Date r3----zt.-Ti,z-,-,____.-.
,.... ..,. _____.
Hi E-_-.'._.-7 i ”/'LI-LJ
Method of Payment: (Faxed permit applications will only be accepted with major bankcard) r s- {
❑ Cash ❑ Check ❑ Mastercard D VISA Otiieif '` ' "`' '
Bankcard#: Expires: VIN#: MA. 2
Authorized Signature: ,Pro; :;t �r� ""12--z s�
REVISED 8/25/2005 i
i 3uu(Tl;iiG: " 1 1
Permit Center
I p®kan 11707 E Sprague Ave,Suite 106 PERMIT NUMBER
Spokane Valley,WA 99206
t5
Valley (509)688-0036 FAX:(509)688-0037 PET-FEE
Community Development www.spokanevaliet.org.com
Residential Construction DI New Construction o Accessory Bldg
Permit Application o Addition/Remodel o Deck
a Other:
SITE ADDRESS 10'7'Z Z 1. 3�
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: L,t to 61k L I` oAde osc ices'f
,RS- i i . al.:v; . r .V . ' '�, i..§ dam t i OATIV." Y3 ?-'F :M 'c, -t-a.y' t.
� , ` � 3Y 1
i s
Name: D t o W►aACk c. c tbA 5 : Name: b j a moria f•.oc k eedt S t
Address: Address: Z(ooZ. N, S u I l i Jii✓t kJ
City: Zip: City: 9r.)rCi oQ tki(('Q y Zip: 99 z l b
Phone: Fax: Phone: tt zi/- <3.9 6 K Fax: 9 z6 " 8-02,-/
r ." ,
Lic No: .Exp.Date:
e4402.eal0i a _ lateff.. V* :a City •Business •Lic No:
Name: Pam l Cr °
Phone: Z11, N C1 Z i(
Describe the scope of work in detail: Cost of Project: $ 75, ow
(3‘), 1t u tkt ,.l S F k.
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK: L.
DIMENSIONS:y X �I. #OF STORIES: C TOTAL HABITABLE SPACE:
/54k
MAIN FLOOR TO SQ. eu FLOOR SQ.FTG:N1� UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG: S AREA: /WIN
IS
FINISHED BASEMENT GARAGE SQ.FTG: DE COV.PATIO Q.FTG: 30%SLOPES ON
SQ. FTG: 0 'S L� 3- y PROPERTY: /VI/4
#OF BEDROOMS: 3 CONSTRUCTION TYPE: HEAT C :- SEWER OR SEPTIC?
Lka.)a, Frim Naftpra( &t-s F,ir,na cc, S.e(,M1
DISCLAIMER
The permitee verifies,acknowledges and agrees by their signature that: 1) If this permit is for construction of 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 M 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) This 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 VASCLIt
' Date 1 3 Z9 f }
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash 0 Check 0 Mastercard D VISA 1 j Oiti t '`i `' i
Bankcard#: Expires: VIN#: A •. -
i“ , t iiii
Authorized Signature; i rf.- t r. ,,. 12-,,,z S1
REVISED 8125!2005 •
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