2003, 05-30 Permit App: BD-2003-0493 GarageCity of Spokane Valley PHONE (509)688-0036
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
FAX # (509)688-0037
PERMIT #
BUILDING PERMIT APPLICATION
Box 1 OWNER --Z14- 10A-6So JOB LOCATION 412/ 1), la/ Si -
OWNER'S ADDRESS 92/N. dell Sf CITY-10,1,e9/-gegj
DESCRIBE JOB %/e B.v/ /J, / !- s/r� ay X 3o $ /D
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTORS NAME Exeidiu-- f4aG/ ,5/r,,ea{tnt/ �.. PHONE %Z/• /?OD
CONTRACTOR'S ADDRESS /WI! E. ( CITY
CONTRACTOR'S REG.# £SXCAL55 ono CS EXPIRATION DATE 02 ;02541,5"
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT /4.4..-/ Yo- PHONE %Z/' /3Co
ADDRESS AEl. /50 K /4/11( CITY _5;ovietAtt ZIP 9%Z/y
BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $ _
BOX 6 PROPERTY TAX ACCOUNT NUMBER 6-57 p 3. /Los
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE 744 Pr
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING /Y FT.
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL / INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST • MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES T. s.'MT EWORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT �G�l
DATE 5.23`
I hereby authorize the City of Spokane Valley to char: the fee for this permit to my credit card:
Visa Mastercard
Print the name of the Holder
Expiration Date
Signature
05/23/2003 e09:03 U COWed d9 241567
rit-tr
:ity of Spokane Valley
1707 East Sprague Avenue, Suite 106
pokane Valley, WA 99206
PERMIT #
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PAGE 01
IU Sd415bY H.01/02
BUILDING PERMIT APPLICATION
PHONE (509)688-0036
FAX # (509)688-0037
Box 1 OWNER -Zirt- �k5 5aA) JOB LOCATION 4/2/ 4. 14//
OWNER'S ADDRESS V21,04. de// $f CITY. o,l i7PHONE Segni
DESCRIBE JOB 4/B Aid /41)11.- .f- sitar o2t' c 3o 7c ID
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED ✓
PARTNERSHIP CORP.
BOX 2
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CONTRACTOR'S NAME,Fxattiimrfke./ .�/rec�/ls r. en:-
i
. PHONE ial• flow
CONTRACTOR'S ADDRESS Nip? .8.. leg I CITY U's&e
CONTRACTOR'S REG.# 4'64!..5 S DOo d a EXPI
(CARO MUST BE PRESS
TION DATE a - 7Y • 05—
TED
S
TED AND COPIED OR VERIFIED)
_=====__=======___.
PHONE x%7/-/307
1
BOX 3 CONTACT PERSON OF PROJECT 44— O /�
CITY Seo ZIP g7 c-/�%
=acs om�
ADDRESS RQ. /Pi0 x / y54
iYMaMmm ----
BOX 5 ESTIMATED PROJECT COST $
EXISTING BLISG. VALUATION $ •
• BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
6-5--/F- frac
Aa=11TriaIFaMaaiomCL
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR /
BASEMENT UNFINISHED
OTHER
/ DECK
CARPORT / TOTAL /
mma===mcamMMaaaa
1ST FLOOR / 2ND FLOOR /
BASEMENT FINISHED
/ GARAGE 740 2r
HEIGHT TO PEAK OF BUILDING FT.
__________ —=cxmzmmmmmmannmv
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE SQ. FT.
BOX 8 ( ) SINGLE FAMILY
( .) MULTIFAMILY (NO. OF UNITS )
( ) COMMERCIAL/INDUSTRIAL
( ) TENANT IMPROVEMENT
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST • MY KNOWLEDGE AND FURTHER THAT I AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES Ti • E W !.;: FOR WHICH THE APPLIC TION IS MADE.
OWNER / AGENT
DATE S '23 o
I hereby authorize the City of Spokane Valley to char the fee for this permit to my credit card;
Visa Mastercard ^^^— __-- --^— Expiration Dam
Mutate name of the Holder u ature
MAY 20 2003 09:02
5093241567
PRGE.01
1LL £
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04/22/2003 14:20 5093241567
7.
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FINAL AS—BUILT INSTALLATION
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REMARKS (Ccilitinued):
THE UNCATION Mr TUC 00-417E
;YSTEN REPRESENTED BY THE ORAN1Ni
SHOT TO OE CONSTRUED S N
EXACT LOCAftON OF THE SYSTEu,
3173
APR 19 2003 14:18
509324167 POE. 01