2007, 01-10 Affidavit of Exception cm wCITY OF SPOKANE VALLEY (Staff Use Only)
Spokane Community Development Department
- Vdllev Current Planning Division DATE SUBMITTED: RECEIVED BY:
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ACL 11707 East Sprague Avenue, Suite 106 Pius #:
Spokane Valley, WA 99206
Tel: (509) 688-0197
Fax: (509) 921-1008 AFFIDAVIT OF EXCEPTION
planning(la spokanevalleY.orq
I,(PRINT NAME) ' ri , the undersigned applicant fora Washington
State and Spokane Valley Master Business license, hereby swear that the following information
regarding the business listed on my license application and based at my home address at
is true and correct:
1. There are no exterior alterations to my residence or any accessory structure(s) which change the
residential character of the property;
2. There are no goods or commodities stored on the premises (including accessory structures);
3. Goods and commodities associated with the business are not delivered to the premises;
4. There are no business customers visiting the premises; and
5. There are no signs or window displays on the property related to the license for which I have
applied.
I acknowledge that any change in the in the foregoing conditions, resulting from change or expansion in
business conditions, will require the issuance of a Home Profession Permit. I further agree to report any
change in these conditions to the Spokane Valley Community Development Department, Planning
Division, within 30 days.
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Sigr ture ` Date
Signed and Sworn to before me this (L day of 'GLo , 20 G),- .
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V c9 NOT A �% NOTARY PUBLIC IN AND FOR THE STATE 4{0F WASHINGTON
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yam:, 1)41151-1C Residing at ,51LZ L tat
l�� ?s ,pT.,..•gyp?" My appointment expires: G-a2
AFFIDAVIT OF EXCEPTION Page 1 of 1
1/10/2007