2007, 08-03 Permit App: 07003040 ReroofPermit Center
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PERMIT NUMBER: �. 1 1703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206 PERMIT FEE: r7J
(509)688-0036 FAX: (509)688-0037
www. spokan eval l ev.ora
Community Development
Residential Construction ❑ New Construction ❑ Accessory Bldg
Permit ApplicationAddition/Remodel E] Deck
ri Other:
SITE ADDRESS: �% �! q F et S t f� ��a�er �e ,e LJbO ro
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ASSESSORS PARCEL NO: �%Y0� l : C�CoI LEGAL DESCRIPTION: /yi� N f6jot e s A � 7 L 1 D 8,
Building Owner:
Name:
TOTAL Hl�BITABLE PACE:
Address:
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City: S 1 Q e
State: w" Zip:
Phone: 509 _.gq �- O tos
Fax:
Contact Person
Name: In , u.F (,A Y
Phone: ^j Oct — i?q / 'd l Fis
ibe the scone of work
Proposed Use: '�,- v G 1
il:
�f ol"
Contractor:
Name: J
Address:
City: State: Zip:
Phone: Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
of Project:_ $ QG��
Ic
**************The followine MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO$PEA
# OF STORIES:
.�
TOTAL Hl�BITABLE PACE:
yDIMENSIONS:
Co',(, 7'
g Y2 el
MAIN FLOOR TO SQ.
2 FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
FTG: 1 �
M �
� )
AREA:
FINISHED BASEMENT
GARAGES . FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
SQ. FTG: /'3D11
5a 19
MA
PROPERTY: /1J0
# OF BEDROOMS:
CONSRUCTION TYPE:
HEAT SOURCE-
SEWER OR SEPTIC?
w i f�, �
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S etz,,e r
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 processe .
SIGNATURE: DATE:
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/15/07