2012, 07-13 Permit App: BLD-2012-1108 Demolition GarageSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenterOsDokanevalley.oro
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: A). / //8 , 4va
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME: d0
MAILING ADDRESS:
- 1Y/8 /1rwva-U
CITY: 4044
CONTACT PERSON NAME: 1Z--Q.-
PHONE: — .S86 FAX:
STATE:
CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
P : OJECT DESCRIPTION (Please Provide Site Sketch
Site Plan Provided /(5 Notice of Intent # � C� �} t---1-7 7- L 7Z7
Spokane County Utilities has approved the disconnection /2 o 3 Z
Describe the scope of work in detail
let
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to b- ubmitted.nd subsequently approved before this application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of 1
http://www.spoka neva lley. org/filestorage/ 124/938/210/948/ 1496/Demolition_ Permit_1-11-11.doc
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