2012, 02-09 Permit App: 12000294 InsulationFValley'
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
perm itcenterClosnoka nevalley. orq
(Staff Use Only /n� /
PERMIT NUMBER: la- VL
PERMIT FEE: ` 73. -t,
COMMERCIAL (NON-RESIDENTIAL) CONSTRUCTION PERMIT APPLICATION
® NEW CONSTRUCTION TENANT IMPROVEMENT ItOTHER
SITE ADDRESS: I wrj 1 E LfLl40- F.; FALC
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: RA.Asti...1.—rioe Ht�S S
MAILING ADDRESS: EL). &OA 33 F'S
Cm: Pps i FA C vj
CONTACT PERSON NAME: / API
p
PHONE: G00, /Cf `".4,. L1-.5-4 ce,y
STATE:
ZIP: 93 /3?7
FAX:
CELL:
. CONTRACTOR NAME: V c_-ro i p N. t»
MAILING ADDRESS: Lj 2.0 I�D"1n�7'hi GST ?.LV1
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CITY: (iO -t&(1...
PHONE: -7.4)75- 11--7 1 )oop
CONTRACTOR LICENSE No.: C-j-oa q (okat4 II
ARCHITECT/COMPANY NAME:
--f1 cisi- STATE: �`ry_
FAX: -O k "- k0 43
EXPIRES: p :�(Z , CIN BUSINESS LICENSE NO.:6p0j7 '4, el 2—
a..3 E
t5.30
CELL:
MAILING ADDRESS:
CITY: -STATE:
ZIP:
PHONE: FAX:
CELL:
NAME OF OCCUPANT OF STRUCTURE: IA00e4(E-Ci
PHONE: FAX:
CELL:
CONTACT PERSON NAME:
PHONE: FAX: CELL:
DESCRIBF,,THE SCOPE_OF WORK IN DETAIL; J1.‘7-• w c -St& .
TYPE OF PROJECT:
TOTAL BUILDING SQ FT: 750
HEAT SOURCE:
FIRE SPRINKLERS:
PRIMARY OCCUPANCY: Z.—
SQ FOOTAGE: 7S6
SECONDARY OCCUPANCY: --
SQ FOOTAGE:
TOTAL COST OF PROJECT: $ GTOD •
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 be submitted and subsequently approved before thls application can be processed.
fi.4 JA Date: %1�'1 / /
Updated 1-10-2011 Page 1 of 1