2013, 04-17 Permit App: BLD-2013-0673 PoolCommunity Development Department
Permit Center
"`' 11703 East Sprague Avenue, Suite B-3
S
nn orpokane Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
Valley permitcenter(aspokanevallev,orq
Project # 3(Q _i3-.6�3
RESIDENTIAL CONSTRUCTION PE MIT itakicriiiEM
❑ NEW CONSTRUCTION ADDITION/REMODEL ❑ ACw9IY4i3tLDING
El DECK El OTHER
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SITE ADDRESS: /v 11(E cf7lW
ASSESSORS PARCEL NO.:
"SV PFRMIT CENTER
LEGAL DESCRIPTION:
SUB # r r1 REV. #
BUILDING OWNER NAME:
NAME:
ADDRESS: /0 5l.5 E 47"
CITY:
PHONE:
pr- U
STATE: v4 ZIP: in.20D
FAX: CELL
CONTACT NAME:
PHONE: 30.41/1.G
FAX: CELL:
CONTRACTOR NAME: Deo( (,k✓14 ii/LC,
MAILING ADDRESS: Pio Eok 149 2- 7
CITY:
PHONE:
'polzitke, V
CS(5g) 4z' -65 S
T4 7 eJI ck
STATE: (A9
FAX: (Jai) 9211- 7V9
CONTRACTOR LICENSE No.: lb- CL' W1*..(i1CPEXPIRES:
CELL:
ZIP: si'f,./ y
609) 1.Y9 805S
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF W
K IN DETAIL AND I DICATE USE & PROPOSED USE:
n
e s.det-�'c t eon ( I g y ce
****YOU MUST COMPLETE THE FOLLOWING****
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type: Ip(
Heat Source:
Sewer or Septic: 50 --
TOTAL COST OF PROJECT: $ 2C, 000
pISCLAIMER
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
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
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Page 1 of 2
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REFER TO STANDARD POOL ENGINEERING STRUCTURAL PLANS
REFER TO STANDARD DIMENSIONS ON AQUA FORM STEPS
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