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2003, 10-23 Permit App: BLD-03-02920 Siding
My of Spokane Valley .1707 East Sprague Avenue, Suite 106 ;pokane Valley, WA 99206 PEST # BUILDING PERMIT APPLICATION 3, ,?-9-0 PHONE (509)688 -0036 FAX # (509)688 -0037 Box 1 0 r' k _ i NIL 4P _ JOB LOCATION OWNER'S ADDRE ! _.. • s i , !, ( - HONE c D-O DESCRIBE JOB _VI �1� 1 V I c.0 >� �1S �} n rt-evr THIS PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORP. CONTRACTOR'S REG. #,) )96e ,e/ C7 .�/ 101FPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT ADDRESS PHONE CITY ZIP BOX 5 ESTIMATED PROJECT COST $ 1p D. ©D EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 3RD FLOOR ! OTHER 1 BASEMENT UNFINISHED / DECK CARPORT / TOTAL 1ST FLOOR / 2ND FLOOR BASEMENT FINISHED ! GARAGE HEIGHT TO PEAK OF BUILDING FT. BOX 8 ( ) SINGLE FAMILY ( .) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL 1 INDUSTRIAL TRIAL_ ( ) TENANT IMPROVEMENT ( )NEW CONSTRUCTION ( ) BUSTING STRUCTURE TOTAL AREA OF PROPERTY SQ. FT. IMPERVIOUS SURFACE _• SQ. FT. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND - CORRECT TO THE BEST OF MY KNOWLEDGE AND RJR ['HER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PE -• RM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT it. i M ' V DATE /Z)---,,93-62:- I hereby authorise die City of Spokane Valley to cba rge the fee for this permit to my credit earls Vies Mastercard Espinttioa Date print theatme of the Holder - - - - - - - -_ - \IA') 15