HomeMy WebLinkAbout2014, 09-09 Permit App BLD-2014-2153 Bathroomg *lane
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CSV PERMIT CENTER
SUB # I �` REV.
RESIDENTIAL CONSTRUCTION PERMIT APPLIC
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 720-2540
Fax: (509) 688-0037
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❑ NEW CONSTRUCTION
❑ DECK
SITE ADDRESS: ' L (2 3 10 4c`'y
ASSESSORS PARCEL NO.:
ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ OTHER
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LEGAL DESCRIPTION:
BUILDING OWNER NAME:
Lin ~.(S z > C
NAME:
S ��VtA-C aSO v\.„
ADDRESS: 2_ Lja3 yy }� C7c y' �C{ Lc; Q
CITY: _5f c kco-tf UC'll ( ( J
PHONE: sOq - U Z5
CONTACT NAME:
Fax:
STATE: l
ZIP: 7C ZO6,
CELL: 6O /e- (:)76 (
PHONE: �a(y l
CONTRACTOR NAME:
FAX: CELL:
MAILING ADDRESS:
Cm:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
'ght to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main F o Q FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement SQ
FT:
Garage SQ FT:
ed Patio SQ
Impervious Surface
30% Slopes on
Property:
FT: --Area:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ 7-1/5O0
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
Date:S, 7 , / y
Updated 1-11-11
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Project # JR-P 2bt` 2($
RECEIVED
SEP 09 2014
CSV PERMIT CENTER
SUB # L/J REV #
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