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2013, 07-12 Permit App BLD-2013-1372 Addition_,,mmunity Development Department (Staff Use Only) Permit Center C1TYoF ��,� 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: Spokane Spokane Valley, WA 99206 Tel: (509) 688-0036 PERMIT FEE: Valley Fax: ftcen 688-0037 z Fax:oer(09) @spokanevalleV.orq RESIDENTIAL CONSTRUCTION PERMIT APPLICATION 0 NEW CONSTRUCTION V ADDITION/REMODEL 0 ACCESSORY BUILDING 0 DECK ❑ OTHER SITE ADDRESS: 1.� 'C7, LZ ASSESSORS PARCEL NO.: " F i �. Z. LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: Pcfi'+ ADDRESS: CITY: rr _i, STATE: v3 Pk- 7SP: PHONE: (50. (.4 ��l ._ r�r r FAX: CELL: (��^� L CONTACT NAME: !"" .➢. 1,04 PHONE: Y_,,t„i.:MM'' FAX: J..'w CONTRACTOR NAME:,. /"E 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: ****YOU MUST COMPLETE THE FOLLOWING**** Height to Peak: V,.t!k- f:=- =' _1:''W Dimensions. `` w No. of Stories: .,Mw...,._ Total Habitable Space: _ Main Floor SQ FT: Upper Floor SQ FT: ^' 2.. 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: Heat Source: Sewer or Septic : ^-=ry -:r' TOTAL COST OF PROJECT: $ 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 r; //1/47/+, i Date: - /3 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 \N e5-r _..PLANNING DEPT. APPROVED DATE: -4I I?"I I�