2003, 04-25 Permit: BD03-180 Reroof, Siding, WindowsCITY OF
SPOKANE VALLEY
SITE INFORMATION
Site address: TIC_ P P PAA
Parcel number: g�D3/.
Subdivision:
1�
BUILDING PERMIT No. bp() -:S ,160
PROJECT INFORMATION'
Permit use for: Q opr,- I i,y S iGQ �'L f� tk) i ncEc� S
Applicant:. 01, 1,,, .e r'
Address:
Zoning: Water District: Contact:
Owner: l g S. P Phone #:
Address: 0 �,V , Project name:
City State\,Q-6 Zip �� Sprinklers ? _ Fire Alarm ? — Security Alarm ? _
.............Onr.rrrr..rr..r.r...r. mum NON rr.Manx Nauman ........rrNoonan .. Nunn r..rr.rmwon rrr.r.r.r.rl
Buii ing
■■.■■.....■■...■■......■rrrr.■......■■■■........■■■■.■■..■■....■�.■........■■.■■..............r....r........�
Contractor Co t A M �Q � License #
Occupancy Group 1Q-3 Type of Construction Height Stories Total Square Feet
Category: Q (1= new, 2=remodel, 3= addition, 4= change of use, 5=tenant improvement, 6=mechanical, 7=plumbing,
8=sign, 9= mobile home, 10=demolition, 11=Other
v
Total code value $` 4CO • Permit Fee $ plan Review Fee $ 1 .4/5f State Surcharge $ quo
Surcharge $ Fire Fee $ Planning Fee $ Public Works Fee $
TOTAL FEES $ % . 2_6 AMOUNT PREPAID $
TOTAL DUE $T9, f . ; �
The issuance of this permit does not imply complete approval for construction not in compliance with the codes and standards.
...........................................................................................r.................1
NOTES / CONDITIONS OF APPROVAL
MEN man no mummummmumm MEN 0 mommom a Sam ON on MOURN Eno a Mann a MUNN MEN Eno onommummum own NON so NON mumamm MEN am MEN NONE no us ENNUI
1 cc to File -1 cc to Permit holder -1 cc to Assessor Issued /� DateJ63
City Of
SPOKANE VALLEY
PERMIT #
BUILDING PERMIT APPLICATION
Box 1 OWNER tin /Scally 5,Sf/AM I? JOB LOCATION It 7D 3 1U,
OWNER'S ADDRESSt, ,,2/,c w x G, neCITYCjqLn Py_ PHONE a Iq- 6 t y g
ROad
DESCRIBE JOB _ -e (�o 6 F , _k2 e Gt, ;,y l „L c% w 4 ct kL y� �. Ci dyi Ct / S id I kl
THIS PROPERTY IS OWNED BY: SINGLE/MARRIEDLI O c '.Ts� l� y S• Sti4 .t..
PARTNERSHIP CORP.
------------------------------------------------------------
BOX 2 CONTRACTOR'S NAME c z, 1- 1(,- S PHONE ;?
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) ,
CENSUS NUMBER LOT NUMBER
------------
BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTURE
( )
COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
-( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE _ 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.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/ AGENT Sr DATES ,9�� �G� (OVER)
CONTRACTOR'S ADDRESS U-,, 7
P /O /h Iyi (l.r �Zcl CITY C k
CONTRACTOR'S REG.# S NA m P
N !q l Itl ✓ EXPIRATION DATE y
v! c
----------------------
(CARD MUST BE PRESENTED AND COPT
D OR VERIFI D)
BOX 3
CONTACT PERSON OF PROJECT
-----------------------------------------
1_ ,P J ,g:�wig_, PHONE 6 - /4e
---------------------------------------------------
ADDRESSj,t,.7�/D fhrJ�ill�
-----------------------------------------------------------------------
(�� CITY�'llfhr
ZIP Oo
BOX 4
SEWER AVAILABILITY
WATER AVAILABILITY 7ti cn7tt
__ ______ _ _
cid IYv,�.c'hovt is 4-f
BOX 5
____________________________________________
ESTIMATED PROJECT COST $ _3SOd. 0 0 EXISTING BLDG. VALUATION $tOCaO,
O d
BOX 6
PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
ee TIk)e Itlov1h
) J
0 V6Y1d[1.� �1YlA
P33�'��� 7�rep�
l/
A,,/ 1-7k Oi JJeliO y
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) ,
CENSUS NUMBER LOT NUMBER
------------
BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTURE
( )
COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
-( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE _ 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.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/ AGENT Sr DATES ,9�� �G� (OVER)