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2003, 05-14 Permit: BD03-414 Reroof
City of SPOKANE VALLEY (gw- ©03 fc() Lig 0037 PERMIT# F0 t)3 -'-1I 1 BUILDING PERMIT APPLICATION Box" 1 OWNER .p.e, .5c A Gir u„ e JOB LOCATION /7t / S, 19 OWNER'S ADDRESS S' /71/ Aon+ .' 1,T Spa 24 3( PHONE 5 -G DESCRIBE JOB R, aeT THIS PROPERTY IS OWNED BY PARTNERSHIP CORP. MARRIED BOX 2 CONTRACTOR'S NAME PHONE �s G g '3 ( CONTRACTOR'S ADDRESS /91- / 5, Art-tro�„� CITY CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) r 7 BOX 3 CONTACT PERSON OF PROJECT ,t. r JC h i ,fir,,., PHONE S 3 f , t g "? ADDRESS /72./ 5. E?., CITY r k ZIP ??2 /7 BOX 4 SEWER AVAILABILITY WATER AVAILABILITY dY .C.. - BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 3RD FLOOR / OTHER BASEMENT UNFINISHED / DECK CARPORT / TOTAL 1ST FLOOR /4-- / Oo® 2ND FLOOR BASEMENT FINISHED Po / / GARAGE / HEIGHT TO PEAK OF BUILDING S' FT. BOX 8 (XC) SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UMTS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY , SQ. FT. IMPERVIOUS SURFACE 1 SQ. FT. BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. BOX 10 Water Service meter size (if known) Also see BOX 4 BOX 11 Septic Tank — Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND 7ORRECT TO THE BEST • F MY KN EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO 1);/' FORM T `t ""ORK FOR WHICH THE APPLICATION IS MADE. MINER/AGENT DATE �� %�f o (OVER)