2004, 04-22 Permit: BLD-04-04165 Safety Inspect�QT O 00•09\40...p kane
,,00.01,4alley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Job Address:
Description:
Subdivision:
Owner:
Applicant:
Address:
SAFETY INSPECTION PERMIT
1423 S BURNS RD
VERADALE WA 99037-9638
SAFETY INSPECTION OF AN EXISTING ADULT FAMILY HOME CHANGING
FROM 4 LEVEL 11 & III CLIENTS TO 6 - LEVEL II & III CLIENTS
DENSON, R R & C E/SEABERG, K M
Permit #:
Applied:
Issued:
Expires:
Lot: Blk: Parcel No: 45234.4803
DENSON, R R & C E/SEABERG, K M Phone: (509) 927-9752
1423 S BURNS RD
VERADALE, WA 99037-9638
Contractor: Phone:
Address: Lic No:
BLD -04-04165
Zoning:
04/22/2004
04/22/2004
10/19/2004
General Information:
REROOF
MAX NUMBER OF OCCUPANTS
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
SPRINKLER INSTALLED
FIRE ALARM INSTALLED
SECURITY ALARM INSTALLED
Fees:
N SAFETY INSPECTION
6
no
no
N
N
N
Total Calculated:
Deposits/Receipts:
Total Due:
47.00
47.00
47.00
0.00
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 the property own)/
9W -47 -e#41(7 -e#41(' Or) �6 gemf71 d
int Name
Signature
1
S .ff Initials
THIS IS NOT A RECEIPT