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2003, 10-30 Permit: BLD-03-02953 Licensed Care HomeSpokane 4_, F Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: 5. 305$BLAKE RD CHANGE OF USE PERMIT Permit #: Applied: SPOKANE WA 99216-0818 Issued: LICENSED CARE HOME FOR CHILDREN AGES 6 TO 18 - (4) LEVEL I CLIENTS Expires: MAXIMUM ALLOWED IS 6 CLIENTS Lot: Blk: PETERSON, MERRILL BLD -03-02953 10/30/2003 10/30/2003 04/27/2004 Parcel No: 45154.1508 Zoning: PETERSON, MERRILL Phone: (509) 928-7681 1405 E ROCKY TOP LN SPOKANE VALLEY, WA 99206 Phone: Lic No: General Information: Fees: BASIC PERMIT FEE WSBCC SURCHARGE Total Calculated. Deposits/Receipts: Total Due: 47.00 4.50 51.50 51.50 0.00 /0fre Disclaimer: The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit inure to the1 L5 erty owner. C!,, PrintnName CAD Staff Initials rr c� (3,o-ke CSOn Signature THIS IS NOT A RECEIPT b/ )03 Date