2003, 10-24 Permit App: BLD-03-02884 ReroofTO 534184'
APR 1.3 2903 1.61�4 FR
ue Avenue, Suite 106 �� �ns ec.�llh( td /
1p707 E9st Sprague 1 P
Spokane Valley, WA 99206 PERMIT #
BUIL 1ING PERIV AP�X,ICATION
3 JOB S �' JOB LOCATION J ea
Box 1 OWNER_ CITY , PHONE
OWNER'S ADDRESS
-21 o ✓l .
DESCRIBE JOB
r.V�c+r
,`�-��l PHONE G500)685itl03�►
Spokane 1/nlle ' Fax (509)688.0 7
City' , o��
-, ✓4-/'mr
THIS PROPERTY IS OWNEDCORPBY: SINGLEIMARRIED _- -
PARTNERSHIP
BOX 2 CONTRACTOR'S NAME S ecialt Home Products Spokane WA 99202
2222 . Mallon
CITY SP
CONTRACTOR'S ADDRESS
11_09-01
CONTRACTOR'S REO # SPECIW*087JW EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED) w
.r-es�� - PHONE
A S
BOX 3 CONTACT PERSON OF PROJECT.r/
ADDRESS• ---��-_ _�_
_ -- -= ---��. 'Soo,o:
- PVJ COSI n EXtBTING 8LD0. VALUATION $ _
BOX 5 ESTIMATED PROJECT , �_--�-11ON _Ii___
=---` -
BOX a PROPERTY TAX ACCOUNT NUMBER •
LEGAL DESCRIPTION _.yam
—
BOX 7 BUILDING SQUARE FOOTAGE (Existing I proposed) 1ST FLOOR_ f_____...2Np FLOOR..�. -�
! BASEMENT FINISHED 1-.. ,
3RD FLOOR _ —I - SER am ._. __
BASEMENT UNFINISHED / DECK • i GARAGE I
CARPORT_ 1 TOTAL I HEIGHT TO SOF BUILDING �...___
-. � �-= 'LL--�""e ta- ---J14444
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
97RUCTURE
MULTIFAMILY (NO. OF UNITS .,-.�_) ( ) q
IMPERVIOUS
COMMERCIAL I INDUSTRIAL TOTAL AREA OF PROPERTY 80.. g
( ) TENANT IMPROVEMENT SURFACE
BY
TPUE
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE IN> �T I AUTHORIZED BY IS O THE
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURt'H AM •
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION 1S MADE.
This document originally contained DATE
OWNER 1 AGENT •,, di* " • .8_ —tier 6.16b. .
was redacted pursuant to RCW 19.255.010
I he reby tuthcrlse the aglitgliMIN
Vha Miatereud
• •'jI •I•
i i1 01 11.
tfilWivr thio per
eQ
Print the UM. ot'tit* Holder R i c'k
OCT 20 2003 07:44
7 credit card: .
TOTAL PAt;E.02
PAGE.01