2007, 01-17 Permit App: 07000083 ResidenceProject Number: 07000083 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/17/2007 Page 1 of 3
Project Information:
Permit Use: NEW SFR W/ATT GAR
Setbacks: Front 32 Left: 5 Right: 28 Rear: 32
Site Information:
Plat Key:
i w , r,rE+..,� :fi', &An �rori•}wa+"�!"3 °: X..1' .. ...6.:'Md r'."�w•x''&''."�"'b?..¢
Contact: VIKING CONSTRUCTION INC
Address: 2605 W HAYDEN AVE
C - S - Z: HAYDEN, ID 83835
Phone: (208) 762-9106
Group Name:
Project Name:
Name: GREENACRES IRR DISTRICT A
District: East
Parcel Number: 55074.0303
SiteAddress: 2319 N EDEN AVE
Location:: CSV
Block: Lot:
Owner: Name: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE
HAYDEN, ID 83835
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19 Hold: ❑
Area: 9.50 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Driveway/Approach
Released By:
Originally Released: 1/2/2007 By: TMELBOU
Released By:
Originally Released: 1/17/2007 By: jlmain
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released: 1/9/2007 By: MBASINGE
Released By:
Operator: JD Printed By: jmm Print Date: 1/17/2007
Project Number: 07000083 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/17/2007 Page 2 of 3
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
APPROACH -CONST IN ROW
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Description Grp Type Notes
1&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
GARAGE U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
HOOD -TYPE II
Approach
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$50.00
$50.00
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,160 $105,977.60 1,160 $105,977.60
1,602 $119,637.36 1,602 $119,637.36
922 $17,518.00 922 $17,518.00
Totals: 3,684 $243,132.96 3,684 $243,132.96
Units Unit Desc Fee Amount
1 SELECT $1,800.15
1 SELECT $4.50
1 SELECT $720.06
Permit Total Fees: $2,524.71
Mechanical Permit
Units
1
1
3
1
4
Operator: JD Printed By: jmm
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$3.00
$12.00
$40.00
$77.00
1/17/2007
Project Number: 07000083 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/17/2007 Page 3 of 3
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Notes:
Plumbing Permit
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
Units
3
5
2
2
Payment Summary:
Permit Type Fee Amount
Approach $50.00
Building Permit $2,524.71
Mechanical Permit $77.00
Plumbing Permit $114.00
1
1
1
1
3
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Invoice Amount
$50.00
$2,524.71
$77.00
$114.00
Fee Amount
$18.00
$30.00
$12.00
$12.00
$ 6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$0.00
$114.00
Amount Owing
$50.00
$2,524.71
$77.00
$114.00
$2,765.71 $2,765.71
$0.00 $2,765.71
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: jmm Print Date: 1/17/2007
Project Number: 07000083 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW SFR W/ATT GAR Contact: VIKING CONSTRUCTION INC
Address: 2605 W HAYDEN AVE
C - S - Z: HAYDEN, ID 83835
Setbacks: Front 32 Left: 5 Right: 28 Rear: 32 Phone: (208) 762-9106
Group Name:
Project Name:
Site Information:
Date: 1/9/2007 Page 1 of 3
Plat Key: Name: GREENACRES IRR DISTRICT A District: East
Parcel Number: 55074.0303 Block:
Lot:
SiteAddress: 18024 E MONTGOMERY AVE Owner: Name: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE
Location:: CSV HAYDEN, ID 83835
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19
Area: 9.50 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Hold: II]
Depth: 0 Right Of Way (ft): 0
Review Information: ,• 4 • ". • . • ° '4;,° ' Nif P•4;.•°," • • 'Nri` .*" 4 • °.°`• • " °•"4' ^, 48,:esatev,,,A,,mptotqat,,,,,,xv,
Review
Building Plan Review
Released By:
Driveway/Approach
Released By:
Landuse/Zoning/HE Conditions
Released By: iNdl."-•1
Sewer Review
Permits:
Released By:
Operator: JD Printed By: JD
Print Date: 1/9/2007
Project Number: 07000083 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/9/2007 Page 2 of 3
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
APPROACH -CONST IN ROW
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Description Grp Type
1&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
GARAGE U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Notes
Contractor: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
HOOD -TYPE II
Approach
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$50.00
$50.00
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
This Application:
Sq Ft Valuation
1,160 $105,977.60
1,602 $119,637.36
922 $17,518.00
Total Project:
Sq Ft
1,160
1,602
922
Valuation
$105,977.60
$119,637.36
$17,518.00
Totals: 3,684 $243,132.96 3,684 $243,132.96
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,800.15
$4.50
$720.06
$2,524.71
Firm: VIKING CONSTRUCTION
Phone: (208) 762-9106
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
4 NUMBER OF
Operator: JD Printed By: JD
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$3.00
$12.00
$40.00
$77.00
1/9/2007
Project Number: 07000083 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/9/2007 Page 3 of 3
Plumbing Permit
Contractor: VIKING CONSTRUCTION Firm: VIKING CONSTRUCTION
Address: 2605 W. HAYDEN AVE
HAYDEN, ID 83835
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Phone: (208) 762-9106
Units Unit Desc
3 NUMBER OF
5 NUMBER OF
2 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$18.00
$30.00
$12.00
$12.00
$6.00
$6.00
$6.00
$6.00
$18.00
Fee Amount Invoice Amount Amount Paid
$50.00 $50.00 $0.00
$2,524.71 $2,524.71 $0.00
$77.00 $77.00 $0.00
$114.00 $114.00 $ 0.00
$114.00
Amount Owing
$50.00,
$2,524.71
$77.00
$114.00
$2,765.71 $2,765.71 $0.00 $2,765.71
,oRa ticam cv. ra. a ,
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD
Print Date: 1/9/2007
SOkane
VahIey
Community Devel pm. :t
Permit Center
11707 E Sprague Ave, Suite` 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Residential Construction
Permit Application
DEL2006
PER IT N1J 3ER:()f
PERMIT FEE:
ew Cozstrtction
❑ Addition/Remodel
o Other:
_mac CciiuI y plug
❑ Deck
SIT.
DRESS Lc - C> - ve_IGJC0,
ASSESSORS PARCEL NO: 11L\ -L -2-(D.3 LEGAL DESCRIPTION: P-) qc J Irl `j
Btiiidin g owner
Name: '0,1),U
Name:
�pc\
City:
Zip:
Address:
Fax:
• C -"v
`.
n qt -e_
City:
{
1CW/\
Zip:
)':)
Phone:
X:).) "Ci I VU Fax: 1 i c) - u`S6-7
Name:
Phone:
Describe the scope of work in detail:
Contractor : _,:.
Name: '0,1),U
Address:
City:
Zip:
Phone:
Fax:
Lic No: VI ILI Qe..,G kl;6
Exp. Date:
City Business Lic No:
Cost of Project:
**************The following MUST be complete: (write N/A if not applicable)***************"******
HEIGHT TO PEAK:
Z.3'- 7"
DIMENSIONS:
5Z'' wI'
# OF STORES:
Two
MAIN FLOOR TO SQ.
FTG: 1160 0-
2"`' FLOOR SQ. FTG:
1 Got, nl,
UNFIN BASEMENT SQ. FTG:
/VIA
TOTAL HABITABLE SPACE:
2
76Z. Dom"
IMPERVIOUS SURFACE
AREA: 3Z32
FINISHED BASEMENT
SQ. FTG: NWA
GARAGE SQ. FTG:
92. Z D V--
DECK/COV. PATiO SQ. FTG:
Nle
30% SLOPES ON
PROPERTY: 1Vo
# OF BEDROOMS: 3
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
CONSTRUCTION TYPE:
C.0ov.
HEAT SOURCE:
6A5 FORCED AfR
SEWER OR SEPTIC?
_` "`JI
Signature l / \
t\ �, �� �'C. _1\�_�1,1 fir ` C/1
Method of Payment: (Faxed permit applications will only be accepf d with major bankcard)
D Cash ❑ Check
Bankcard #: Expires: ViN#:
Authorized Signature:
Date 113
❑ Mastercard ❑ VISA
RSVIS=D 6,26,2005
❑ Other
SOorkane
��' Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevallev.ore.com
Mechanical Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ❑ Residential
SITE ADDRESS
Building owner
.
Name: `1 <'i 'inn 1,t 1; 1(-,\.-4't 1 (: 1 i--,-.‘ �LA,.
Phone: gt1Sy1,' )L,-) i in tt :•
Fax Ij'tf-'..- ilii;~.-ll`i'l
Address: 1� (LJ-. ,(.- , 1 ir'h Q -4f-1' i :\ I•A1. f'
,
CitY t1'i; I; 1)i\ i!\State
, j r'tt Zip Y!,-'‘,
Contractor
t
Name: 0 ii'" i V, : tri \
Phone:
Fax:
Address: t'
City
State
Zip
License No:
City Business License No:
Contact
..
Name:
Phone:
DESCRIPTION OF WORK
1 FUEL BURNING APPLIANCE
2 FUEL BURNING APPLIANCE
3 UNLISTED APPLIANCE (Additional Fee)
4 UNLISTED APPLIANCE (Additional Fee)
5 USED.APPLIANCE (WSEC min. AFUE rating)
6 USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 100,000
More than 100,000
Equal to or less than 400,000
More than 400,000
Equal to or less than 400,000
More than 400,000
t# OF UNITS X
X
X
COST
$12.00
$15.00
= TOTAL AMOUNT
X
$50.00
X $100.00
X
$50.00
X
$100.00
7 BOILER/REFRIGERATION
8 BOILER/REFRIGERATION
9 BOILER/REFRIGERATION
1 - 100M BTU
101 - 500M BTU
501 - 1,000M BTU
X
$12.00
X
$20.00
X
$25.00
10 BOILER/REFRIGERATION
11 BOILER/REFRIGERATION
1,001 - 1,750M BTU
More than 1,750M BTU
X
$35.00
X
$60.00
12 GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
13 RANGE
X
$10.00
14 DRYER
X
$10.00
15 FUEL BURNING WATER HEATER
1
X
$10.00
16 MISC. FUEL BURNING APPLIANCE
X
$10.00
17 GAS PIPING (each outlet)
X
$1.00
18 DUCT SYSTEMS
X
$10.00
19 VENTILATING FANS
X
$10.00
20 AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
21 AIR HANDLER (DOES NOT include ducting)
22 EVAPORATIVE COOLERS
23 TYPE I HOOD
Greater than 10,000 CFM
X
X
X
$15.00
$10.00
$50.00
24 TYPE II HOOD
X
$10.00
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
26 AIR CONDITIONER
3-15 TON
X
$20.00
27 AIR CONDITIONER
15-30 TON
X
$25.00
28 AIR CONDITIONER
30-50 TON
X
$35.00
29 AIR CONDITIONER
More than 50 TON
X
$60.00
30 LPG STORAGE TANK
X
$10.00
31 WOOD OR PELLET STOVE/INSERT
X
$10.00
32 WOOD STOVE - FREE STANDING
$25.00
33 REPAIR & ADDITIONS
34 VENTILATION SYSTEMS
35 VENTILATION MECHANICAL EXHAUST
36 INCINERATOR - RESIDENCE
37 INCINERATOR - COMMERCIAL
METHOD OF PAYMENT:
❑CASH 0 CHECK 0 VISA 0 MC
CARD #:
AUTHORIZED SIGNATURE:
X
$15.00
X
$12.00
X
$12.00
X
$19.00
X $22.00
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
DEC 06 2005 09:30 FR
Permit Center
rka 11707 E Sprague Ave, Suite 106
Spokane Vaflcy, WA 99206
(509)688.0036 PAX: (509)688-0037
Community Development www,snokancvallev. or con
Plumbing Permit Application
72 �1
srrE ADDRESS: ,r- -, iCi r:� �._.
TO 12087624507 P.01/01
PERMIT NUMBER:
PERMIT FEE:
Commercial 1x1 Residential
B�ildlogowner \) ,V I XT i ( C'n=.-i!, i (1 Ii` 1
1
. • .
N8A1e: `
ir �( (. 1li� i ( t t 17` - :-� h' ! i /' -� I C+ ^i
X
I� -
Phone: -I t%1'°. - �� � ; •,. � Ci (&li' Fax: 14 l -P, --) (t•,••.' l - •••/•{:, Z
Address: r• i ; S tt." lar'; ',i. , v- 1.-1 ;•e
TOTAL AMOUNT
City. C -IL..-. t Gt;, r'1 State: 1. P) zip: L, ;'i, -V:
L
Coatractur
WATER CLOSET BIDETS
+.
Name:
$6.00
Phone: Fax:
Address:
2
• City : State: Zip:
License No:
License No:
41111.1.1•1.CityBusiness
Contact: „
X
$8,00
Name:
Phone
AUTHORIZED SIGNATURE:
RP/4E1)9r26MS
** TOTAL PAGE . 01 **
DESCRIPTION OF WORK
1
t: OF UNITS
X
COST
.
TOTAL AMOUNT
1
TOILETS
WATER CLOSET BIDETS
x
$6.00
=
2
URINALS
X
$8,00
=
3
7U851
X
$8.08
=
4
SHOWERS PER TRAP
BATH, STALL ON-SITE BUILT
X
86.00
=
-_.,
5
SINKS
LAVSIBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY. FOOD, PREP/CULINARY MEAT
5
X
$6.00
=
8
DISHWASHER
t
X
86.00
-
T
CLOTHES WASHER
i
X
$6.00
-
1
8
GARBAGE DISPOSAL
I
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
86.00
-
11
FLOOR DRAINS
AREA, CASE, COIL TRENCH, CONDENSATE,
1
X
$0.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS DRINKING
X
$8.00
■
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVgRSALS
X
86.00
=
15
SEWAGE EJECTOR
GRINDER. SUMP PUMP
X
8.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB.
STEAMER
PROOFER, CARBONATOR. SWAMP COOLER
/
X
$6.00
-
17
CROSS C.NNECTIDN DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B_P.D, FOR: VATS TANKS. BOILERS
X
86.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
a
18
MEDICAL GAS ..r outlet
NITROUS OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
-
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
-
METHOD OF PAYMENT;
0 CASH ❑ CHECK
Card#
SUBTOTAL
❑ VISA ❑ MASTERCARD
PROCESSING FEE
835.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
RP/4E1)9r26MS
** TOTAL PAGE . 01 **
S1c,k3ne Vane.,
i Permit . plication
i
PERMIT i 'E'er.
PROJECT ADDRESS '..)-1} �t [—C`ll fl
i T A.l i
i'uI'• TICit'."`iT1:I i C _'J II I.TI %N DATE
L'
Building
Contractor:
%' :' y'�Owner
Name: �l
!
Name: j 0 \.0
Adaress:--
,-z% ,t�;. , (,. ) t -\,c, •7..\.:it,:,t �.f�...
Zip: '6'•)'(;; i l
-"1(1.) -1.136;1
address:
City:.1 i',,;...1f1)l.0 State: tat
Cir3,: State:
Zip:
i.
Phone: .=)i)y 1,cr-eilLf c> FaX: ,105-11,:
Phone: Fax:
Contact. Person
Contractor Lic No:v1t.1t 11.tC��iiLrp Date:
` �"_
Name:
City Business Lic. No:
I'lione: ;=7c,`-'.,-'`j(,..>,.-c=tiCA •.
PROJECT DESCRIPTION (Provide site sketch)
Residential Drivevray
1~:xisr..tne Cur) ta' Gutter
(..;ulverl: Installation
Other Conditions
Commercial/Industrial Driveway
Rural Road Section
�Ml Sidewalk Repair/Construction
Bond/Insurance cenification must he on file with the city.
DISCLAIMER
The permittee verifies, acknowledges and agrees by their signatures that: l) If this pet -mit is for construction of or on a dvrelling, die
dV%1171ulc/vll_ be crnrtd by potable water. 2) Ownership ;f this Ci.of Spokane
)i1TC Vale) 1
elff11111117"e to the property owner. ?) The
signatory is the property owner or has permission l:o represent the properly owner in this transaction. =t) All construction is to he 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. 6) Plans or additional information may he required to he submitted, and subsequently approved before this
application can be processed.
Signature
..__!. Jc ;� of 1'C.' 1');LCI:..
n ash ❑ Cheri:
Eankzard =.
ho .zed Signature:
P.EV!SED 3'9/0E
h isterc«zi
Date t .I d
n \?5A