2004, 06-29 Permit: BLD-04-04759 Tear Off, ReroofSp®bran
"Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206. •
RESIDENTIAL ADDITION/REMODEL PERMIT
Job Address: 10111 E BROADWAY AVE
SPOKANE WA99212
Description: TEAR OFF AND REROOF RESIDENCE
Subdivision:
Owner:
Applicant:
Address:
HENNING, RAELENE F
Permit #:
Applied:
Issued:
Expires:
BLD -04-04759
06/29/2004
06/29/2004
12/26/2004
Lot: Blk: Parcel No: 45171.1218 Zoning:
HENNING, RAELENE F Phone: (509) 921-1986
10111 E BROADWAY AVE
SPOKANE, WA 99212
Contractor: Phone:
Address: Lic No:
General Information:
VALUATION
REROOF
COST OF PROJECT
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
3000
Y
3000
no
no
Fees:
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits/Receipts:
Total Due:
83.25
4.50
87.75
87.75
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 owner.
Print Name
Staff Initials
Signature Date
THIS IS NOT A RECEIPT