2012, 08-15 Permit App BLD-2012-1325 ResidenceSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
oermitcenter@spokaneva Ilev.orci
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
NEW CONSTRUCTION 0 ADDITION/REMODEL
❑ DECK ❑ OTHER l
SITE ADDRESS: 1-)ST'..�L G�//eyi ;� Spc)K&A )%v%/eX (/%zv�
ASSESSORS PARCEL NO.: Ns- mg. 0.9,03 LEGAL DESCRIPTION:0pp BEv ws B1o5 L3
BUILDING OWNER NAME: r:,,,,y Lc'. g
NAME: -cf-LvytAy R. Z —
ADDRESS: 1 PS—z.13Vafleyt.t..Zy> .
CITY: oDi Gj.)=l 6y
PHONE: 5::g' /J /-7279
CONTACT NAME: c^c.� 1 cyll
PHONE: q)4—g3q_7279
CONTRACTOR NAME: S,
0-ACCESSORY BUILDING
STATE: (...04 ZIP:
FAX: CELL:
FAX: CELL:
MAILING ADDRESS:
CITY:
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:
C�ww 6,4 e Fo.
-} {� � ibe'}1r\ . �,�c i- [[1nr� r e+�cf tnaor ca^cfc.i-[—
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: ,5'.
Dimensions: �y. x�,
No. of Stories: 1
Total Habitable _7
Space: S to
Main Floor SQ FT: i
�/ Pr
Upper Floor SQ FT:
Unfinished Basement SQ
FT: 1 -
Finished Basement SQ
FT: WA -
Garage SQ FT:
547ID
Deck/Covered Patio SQ
FT: aaLl
Impervious Surface
Area: 23.3
30% Slopes on zru
Property: N
No. of Bedrooms: lyfie
Construction Type: i Ftpm. Heat Source: N1 !
,Jc� / ___,
Sewer or Septic: _11(%j�-
TOTAL COST OF PROJECT: $/T�r
DISCLAIMER
2G�-20 - /32
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for constructtorr r 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 cal be,processed_
, i CENTER
Signature
D te= c? v
— r —
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_ Permit-_Residential_11-11-11.doc
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