2003, 07-01 Permit App: BD-03-726 MHity of Spokane Valley PHONE (.509)688-0036
707 East Sprague Avenue, Suite 106
okane Valley, WA 99206
PERMIT # BD b3 9 -CP
BUILDING PERMIT APPLICATION
FAX # (509)688-0037
Box 1 OWNER ceoyge JOB LOCATION 7.3"--›-3 ---6- r1-/,4,,4'
OWNER'S ADDRESS CITY✓o,.rd/ PHONE f) -4b cyy
DESCRIBE JOB ,; m C /
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED S /q,9/cam
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME 6n/ey'r 89cef/OF S£/ice PHONE J-o2P/7
CONTRACTOR'S ADDRESS CIN
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT GED t $444elthy kJ&Fc PHONE 9'.26-d3d'% oreoI 92Y -S'S
dove_ ADDRESS,=' -c_ is E6ove CITYOEt9/2:4 .0 IV 1. ZIP 32-
BOX
2
BOX 5 ESTIMATED PROJECT COST $
•
EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER /3y- a 0
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR VIS -C) / 2ND FLOOR /
3RD FLOOR /
OTHER / BASEMENT FINISHED
BASEMENT UNFINISHED /
• DECK / GARAGE Z:20 /
CARPORT / TOTAL /
HEIGHT TO PEAK OF BUILDING FT.
30X 8 (X) SINGLE FAMILY
( .) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
(X) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY
..3V IMPERVIOUS SURFACE 3310
161 'v
72-
SQ. FT.
SQ. FT.
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
ORRECT TO THEBE OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
BOVE PREMISES T.j RFOR /THE WORK FOR WHICH THE APPLICATI N IS MADE.
WNER / AGENT /�
DATE
uif /,.03 -
hereby authorize the City of Spokane V ey to charge the fee for this permit to my credit card: ,
Expiration Date
Tint the name of the Holder
Visa
Mastercard
Signature
APPROVED BY
c2.e
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/4taaei /e2
co x.
Jo' t?LZ Ser 84c K
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,,' S/DES ✓
SPOKANE COUNTY DIVISIUN OF
ANDCODE EvFORCEMMIE
026 WRST,BROADWAY AVENUE OKKA1 E, WA"99260-OO.
Site Information
Project Information
Site Address: 16523 E MAIN AVE
VERADALE, WA 99037
Parcel Number: 45134.2320
Subdivision:
Block: 2 Lot: 20
Zoning: UNK Unknown
Owner: SALLAWAY, GEORGE
Address: 16523 E MAIN
VERADALE WA 99037
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 03004685 Inv: 1 Issue Date: 7/1/2003
Permit Use: SEWER CONNECTION - ARMSTRONG EST
Applicant: SALLAWAY, GEORGE
16523 E MAIN
VERADALE WA 99037
Contact: SALLAWAY, GEORGE
16523 E MAIN
VERADALE WA 99037
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Phone: (509) 926-6399
Phone: (509) 926-6399
Rear:
Permits
Sewer Connection Permit
Contractor: GARY'S BACKHOE SERVICE License #: GARYSBS055KJ
SEWER CONNECTION 1 $85.00 PROCESSING FEE
Total Permit Fee:
FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES 8 3p-5:00 PM MONDAY THRU FRIDAY
Call for inspection prior to cover. ONE WORKING DAY NOTICERIQUIRED.
Contractor or applicant is to field locate and confirm the elevation and.position of sewer stub prior to any other excavation.
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main sewer.
Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure.
This permit must be presented to the job site inspector for verification. To locate; buried cables, gas piping, water lines, etc.
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE "CALL BEFORE YOU DIG" CENTER BE
NOTIFIED. CALL BEFORE YOU DIG AT LEAST 2 WORKING -DAYS IN ADVANCE, (509)456-8000.
Spokane County Code requires the installer complywith all requirements of the Washington State Dept of Labor and Industries, including
those related to trench safety.
$15.00
$100.00
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date
7/1/2003
Processed By: SHATTO, JULIE
Printed By: WENDEL, GLORIA Page 1 of 1
Receipt #
4164
Payment Amt
$100.00
PERMIT