2007, 07-06 Permit App: 07002604 DemolitionSpokane
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Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
waw.spokarievalley.org
Demolition
Permit Application
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PERMIT NUMBER:
PERMIT FEE:
Commercial
Residential
SITE ADDRESS: /l h'ZrS���q£ iri1�
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Building Owner:
Contractor
Name: T ro AA
Address: )10 b7 ZIM .p
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Phone:
Contact Person
Name: &rt
Phone: S-01'
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Describe the scope of work in detail
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o A site plan is provided.
o Spokane County Utilities has approved the disconnection.
o Notice of Intent #
The permittee verifies, acknowledges and agrees by their signature that: 1) Ownership of this City of Spokane Valley
Permit inure to the property owner. 2) The signatory is the property owner or has permission to represent the property
owner in this transaction. 3) All construction is to be done in full compliance with the City of Spokane Valley
Development Code. 4) 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 res (ting development rights granted by any issued permit inure)to the property owner.
Signa
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Method of Payment:
❑ Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07