2010, 08-24 Permit App: 10002555 ResidenceProject Number: 10002555
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/24/2010 Page 1 of 3
Proiect Information:
Permit Use: NEW SFR - SEWER Contact: VIKING CONSTRUCTION INC
Address: 2605 W HAYDEN AVE
C - S - Z: HAYDEN, ID 83835
Setbacks: Front Left: Right: Rear: Phone: (208) 762-9106
Group Name:
Site Information: Project Name:
Plat Key: Name: Range
District: East
Parcel Number: 55191.3203
SiteAddress: 717 S MOEN ST
Location:: CSV
Zoning: R-3
Water District 134
Area: 9,972 Sq
Nbr of Bldgs: 0
Block:
Lot:
Owner: Name: VIKING CONSTRUCTION DBA VI
Address: 2605 W HAYDEN AVE
HAYDEN, ID 83835
SF Res District
CONSOLIDATED ID #19
Ft Width: 0
Nbr of Dwellings: 0
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information:
Review
Building Plan Review
Released By:
Driveway/Approach
Originally Released: 8/23/2010 By: Bdbebout
Released By:
Originally Released: 8/24/2010 By: WMCGAV
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Originally Released: 8/19/2010 By: mharnois
Released By:
Permits: ,
Operator: jmm
Printed By: jmm
Print Date:
8/24/2010
Project Number: 10002555 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/24/2010 Page 2 of 3
Approach
Contractor: VIKING CONSTRUCTION Firm: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE Phone: (208) 762-9106
HAYDEN, ID 83835
Item Description Units Unit Desc
APPROACH -CONST IN ROW
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$52.00
$52.00
Contractor: VIKING CONSTRUCTION Firm: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE Phone: (208) 762-9106
HAYDEN, ID 83835
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB 1,342 $132,790.90 1,342 $132,790.90
2ND FLOOR R-3 VB 1,790 $132,835.90 1,790 $132,835.90
GAR WOOD U-1 VB 759 $14,421.00 759 $14,421.00
Item Description
RESIDENTIAL PERMIT FEE
WSBCCSURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 3,891 $280,047.80 3,891 $280,047.80
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Fee Amount
$2,007.35
$4.50
$802.94
Permit Total Fees: $2,814.79
Mechanical Permit
Contractor: AIR DESIGN INC Firm: AIR DESIGN INC
Address: 1807 E FRANCIS AVE Phone: (509) 487-4328
SPOKANE, WA 99207
Item Description Units Unit Desc Fee Amount
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $13.00
GAS PIPING 3 # OF UNITS $3.00
RANGE 1 NUMBER OF $10.00
HOOD -TYPE 11 I NUMBER OF $11.00
Operator: jmm Printed By: jmm
Permit Total Fees: $37.00
Print Date: 8/24/2010
Project Number: 10002555 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/24/2010
Contractor: DALE THOMAS PLUMBING &
Address: 101 W PRAIRIE SHOPPING CTR #56
HAYDEN ID 83835
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER HEATER - ELECTRIC
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Plumbing Permit
Page 3 of 3
Firm: DALE THOMAS PLUMBING & HE
Phone: (208) 667-9217
Units Unit Desc
3 NUMBER OF
7 NUMBER OF
2 NUMBER OF
2 NUMBER OF
I NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$18.00
$42.00
$12.00
$12.00
56.00
$6.00
56.00
$6.00
$6.00
$18.00
$132.00
Notes:
Payment Summary:
Permit Tyre
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
552.00
$2,814.79
$37.00
$132.00
Invoice Amount
$52.00
$2,814.79
$37.00
$132.00
$3,035.79 $3,035.79
Amount Paid
50.00
$802.94
$0.00
$0.00
Amount Owing
552.00
52,011.85
537.00
5132.00
$802.94 52,232.85
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm Print Date: 8/24/2010
Rei — r. r `°1r C D
Lip et {ane 1 J JO'IESyraue.`ve;SF ue B-3
o:aneValle}'„YJ406 11
(509)Q 05361 1
(509)688-0 37
Community Developipeoiuct
Residential Cons:
Permit Application#.= --
PERMIT NUMBER:b/,c:
PER!VHT FEE:
New Construction
Addition/Remodel
Other:
Accessory Bldg
Deck
SITE ADDRESS. 71 7 5 . frio C= \V 5 l ,
ASSESSORS PARCEL NO: LEGAL DESCRIPTION
leaps 0640Ped5,74Pet
Building Owner:
Contractor:
Name: I�Lr1 rOc\SV vxx 1lt,
Address:ryh06Q,3 \1„^ WCC/City: \ \ (\ J1ci l� ttCX�$tate: 3 Zip: g"
Name: �/`,.� (tW1511 A ,V .
Add' ess:
City:
State: i Zi):
Phone: Fax:
Contact Person
Name:
Phone:
Contractor Lic No:
Exp Date:
City Business Lic. No.v , 9--O
I�Cltl �
Describe the scope of work in detail: Cost of Project: $
Proposed Use: -
*************The following MUST be complete: (write N1/A.if not.applicable)*-
"HEIGHT TO PEAK. 261
DIMENSIONS: ��,
# OF STORIES:
TOTAL HABITABLE SPACE.
13a
MAIN FLOOR TO SQ.
FTG:
I-547—
2"" FLOOR SQ.'FTG:
1 7/cl0
UNFIN BASEMENT SQ. FTG.
Ki
IMPERVIOUSSURFACE
AREA: ZCJ 1Z S, F.
FINISHED BASEMENT
SQ. FTG: t j .
GARAGE SQ. FTG:
75t'
DECK/COV: PATIO SQ. FTG:
30% SLOPES ON
PROPERTY: IQ "-lc
# OF BEDROOMS:
4
CONSTRUCTION TYPE
'g_6clOSNIT1n1„--
HEAT SOURCE:
6AS FOQC D Ate
SEWER OR SEPTIC?
S5u P
The permitee verifies, acknowledges and agrees by their signature than 1) If this permit is for construction of 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) This 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
this application gaAbe processed.
SIGNATURE
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 2/15107
\Of \N\ %aid
❑ Check
DATE:
❑ s.ercard 0 VISA
Expires: VIN#:
Valley.
Permit Centcr
11703 E Splaeuu .Ave, Sure F i
Spol:ane Valley, WA 99205
(5.09)6SO-0036 FA;;. (509r',i
clllw.s Dal: aver a ilcv n.+
Community Development
Plumbing Permit Application
PERMIT NUNd6ER:
PERMIT FEE:
Li Co;:Imeicial jxiResidential
SITE ADDRESS: e\ S- `"'0QV\
Building Owner
Name; Pl1onc:' fax
\i'4_t��- ri1-��.�I;�'1 SII,(, .lrtr. 11.,a-LI31)7
Addles:kii ell,: Style 1 ii zip. -. .,
il lir
Cmdraclor
//(( �
1�ain U'v\Ct (vk„Inl 4� "._ Enz.
AJdlcsS: Slate' Zip.
License 1,161-\^\ " O ctQ\m cil V e q 4)5 Ci.y Bus .`•.o i.ic'
Cer,lncl �
Nome Phone
DESCRIPTION OF WORT(
R OFUNITSX
COST
=
TOTAL AMOUNT
1
TOILETS
Y.= TEk:::LOSE I, CiDE:.;
J
X
$6.00
=
2
URINALS
X
$600
3
TUBS
a
X
$6 00
=
4
SHOWERS (PER TRAP)
BATH
BAT, STFLL, ON -'-•ITE BUILT
^
'c"}�
X
$6 00
=
5
SINKS
LAVS/BAr I!4S.5AR. F'.^.PR, KI". -HEY.
LAUNDRY. UTILITY, JAi iTOR. P1'2.10$6.00
X-RAY. FOOD %1'FP/CULUJARY MEAT
y
�4
X
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
6
GARBAGE DISPOSAL
X
$6 00
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE' IF c-; '.d :i':HAN'L? L
X
$6.00.
11
FLOOR DRAINS
ARE^., CA.Th,' 711 I%nIiLII
CI `:':dC'+..'TE -
X
$6 00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6 00
=
13
FOUNTAINS, DRINKING
X
56 00
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING, REVERSAL
NSTALI aTIL:i I. ALTERATION, REPAIR.
REVERSALS
X
56,00
=
15
SEWAGE EJECTOR
OF iNDER, SUMP PUMP
X
$6 00
=
16
WATER USING DEVICE
ICE AN/OR ;l : EE MAPER, HCSE BIB,
iT`• .MEF
^;DUFF CARD" iJA SOB, SWAMP
Con; TR
X
$6,00
=
17
CROSS CONNECTION DEVICE
VACUUM 9i,FTi:= ECK VAWE
AND R.P B.P.0 FOR: bAT S. TAP.)S,
BOILERS
X
66 00
=
16
INTERCEPTORS
GREASE TRAP. SAID TRAP.
CHEMICAL HOLDING TANK
X
56 00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56 00
=
20
MISCEI LANEDUS PLUMBING FIYTURE
n
ib 00
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
INDUSTRIAL WASTE INTERCEPTOR
X
$15 00
=
METHOD OF PAYMENT:
SUBTOTAL
DCASH 0 CHECK 0 VISA 0 MC E.'Pli S.'.:
PROCESSING FEE
$35.00
Card)) '.del
TOTAL PERMIT FEE DUE'
AUTHORIZED SIGNATURE:
REVISED 1126/05
Spokane
ate"
Valley.
Community Development
Mechanical Permit Application
Permit Cenler
11703 E Sprague Ave, Suite 0-3
Spokane Valley, \YA 99206
(509(688-0036 FAX: (5091688-0037
t,vv" snoltancvallia=
n Commercial
PERMIT NUMBER:
PERMIT FEE:
n lal
AUTHORIZED SIGNATURE:
REVISED 1/16105
Building Owner
Phone /4Gf •-)l0 Ci I( (: Fa. _)ern'—lir,(-L(`; WI
Name. 3\1. Li '2' ^Y'r
v7' 1� i or,, r:
Sidle.
CID,: �I!�. 5 l r '- 1_
Address:\licc. 1 1Okt-J•
Gmar Ictar \
• I'hnne. Fax:
Name
• _...i• City. Stale. Zip
Addiass
License No City /lumens Lie'
Conlan
P:nine. 'hone:
DESCRIPTION OF WORK
tl OF UNITS
X
COST
=
TOTAL AMOUNT
APPLIANCE •
Eo.:al,u •_: i.= than 100,000
X
512.00
=
1
FUEL BURNING
APPLIANCE
More Than 110,000
x
515.00
=
2
FUEL BURNING
APPLIANCE (Additional Fee)
Equal to or le:: than 400,000
X
850.00
=
3
UNLISTED
APPLIANCE (Additional fee)
More than 400,300
X
5100 00
=
'
4
UNLISTED
min AFUE rating)
Equal to or less than 400,000
X
850.00
5
USED APPLIANCE (WSEC
More than 400,000
X
8100 00
=
6
LISFD APPLIANCE (WSEC min AFUE rating)
1 - 10010 BTU
X
512.00
7
BOILER/REFRIGERATION
101 - 500M BTU
X
820 00
=
B
BOILER/REFRIGERATION
501 - 1,000M BTU ' '
X
25.00
9
BOILER/REFRIGERATION
,:01 - 1,750M BTU
X
$35 00
10
BOILER/REFRIGERATION
than 1,75u11 BTU
X
56000
=
11
BOILER/REFRIGERATION
.do,'.
X
510.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
1
X
510.00
_
13
RANGE
X
81000
=
14
DRYER
FUEL BURNING WATER HEATER
X
51000
=
15
FUEL BURNING APPLIANCE
X
510.00
=
16
MISC
GAS PIPING (each outlet)
X
$1.00
17
51000
=
iB
19
DUCT SYSTEMS
VENTILATING FANS
X
810,00
HANDLER (DOES NOT include ducting) Equal Ir or less than 10,000 CFM
X
812.00
=
20
AIR
NOT include ducting) :treats: yuan 51 000 CFI.!
X
51500
=
21
AIR FIA IDLER (DOES
X
$10 00
22
EVAPORATIVE COOLERS
THOOD
X
550 00YPEI
=
23
24
TYPE II HOOD
X .
51000
-
25
HEAT PUMP/AIR CONDITIONER 0-3 TON
X
512.00
26
AIR CONDITIONER 4-15 TON
' X
520 00
=
27
AIR CONDITIONER 15-30 TON
X
52500
=
2B
AIR CONDITIONER 30-50 TON
X
535.00
AIR CONDITIONER Mare than 50 TON
X
500,00
=
29
TANK
X
510.00
=
30
31
LPG STORAGE
WOOD OR PELLET STOVE/INSERT
X
810 00
=
IDIPIG
' X
$75 00
=
;2
WOOD STOVE - FREE STAI
' X
516.01
33
REPAIR & ADDITIONS
SYSTEMS
X
512.00
34
VENTILATION --y
EXHAUST
X
512.00
=
35
36
VENTILATION MECHANICAL
INC It J ERATOR-RESIDEtJ OE __ _. __ l_
:
X
519.00
=
37
_ __
INCINERATOR -COMMERCIAL L-
. %
522.00
=
OF PAYMENT:
- SUBTOTAL
METHOD
0 CHECK 0 VISA 0 MC EXPIRES.
PROCESSING FEE
536.00
❑CASH
,-, 0101' TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 1/16105
1CITI'OF1"'' "
e
Community Development
Pei nit Centel
11703 E Spiaeuc Ave, Sriite B-3
Spokane Valley, ,YA 99206
(509)688-0036 FAX: (509)688-0037
wwwspol:nn eve Il ev.orn
Approach Pcrrnit Application
PROJECT ADDRESS �`T\ S'VQf
START DATE
ANTICIPATED COIvJPLETICIN DATE
I3 uild ing Owner:
Contractor:
Name: 7 1 Lin
Mame. \I I t ,• Int.
{
Address' jr)1 pf; i t+.). Orl, Ir'lo ^'\ Pt ,l
Address:
Car '-_5 (V' 1]it-ii"\ - Slate: 1 11 Zip''F1,7rY1S
City: State: •
Zip:
Phone: 1t :G. •11C:-- A'\ ICL• Fax:.)I e,..1(,,)• t.IS6-1
Phone: Fax:
Contact Person . .
Contractor 1-1(\\t9. ty ,i•lio., Y. t,crE tp Date:
Name:
City Business Lin. No:
Phone:
PROJECT DESCRIPTION (Provide site sh •rcin)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions
' Commercial/Industrial Driveway
Rural Road Section
Sidewalk Repair/Constriction
Bnnel/lnsutance certification must be on file with
DISCLAIMER
The permittee verifies, acknowledges and agrees by their signanues that: 1) If this peon t is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Ownership of dais Ciry of Spoltine Valley Permit inure to rhe property owner. 3) The
signatory is the property owner or has permission 1. represent da. property owner in this transaction. 4) All consnvction is to be done in
fill compliance with the City of Spokane Valley Devel: pmenr C.:d: Refer . , d codes are available for review at the City of Spokane
Valley Permit Center. 5) This City of Spokane Valley Permit is not s. permit or approval for any violation of federal, state or local laws,
codes or ordinances. 6) Plans or additional information ma! be se';cired to be subm!tted, and subsequently approved before this
application can he processed.
Sienatur
Altthod anti -meat:
❑ Cash ❑ Check:
Basil:card #:•
.Authorized Signature:
REVISED ]RIOT
D
❑ Mastercard ❑ VISA
Expires.
\ 410
PIN#:
Spokane
Valley®
.For City Usc Only
PLUS Project Ntimber %i� aS�S
Project Address \-7177 `Th 1/' %(
11703 E Sprague Ave Suite a-3'• Spokane Valley WA 99206
509.688.0036 t -Fax: 509.688.0037 t.permitcenter®spokaneJalley.org.
•
As part of our on-going commitment 'to customer service during the review 'proces• Of, yoiirp
roject
application, we arc providing you.with'a TARGET DATE for the initial' technical an,pplicatioreview: If. for.
any reason we cannot meet this date,'. we will contact; you with arevised target date.::; `
•
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your: project application•:will have had its initial technical
review. It not the date for approval or permit issuance.
•Tips fora Smoother Project Application Review
"i.
• .Submit complete, accurate plans and documents. • •. -
E.cb•ti time {nm be require-el./6r re -submittals as project application reviCWers 11'61k'012'i iu/tiple;applications and it
mayhe seve.._l �i_.... ...................7,.................................:__.i :..r ....:.....:.. : "
• Designate 'a specifie contact person to communicate with the City. .
While the pedi-son'designated as the applicants contact person with the, Cin' can hetchanged,„one inuln ideal witkYhe •
e.gtertise for dealing with reviewer comments would he the best choice feu: the entire review process.'•'
• Call staff regarding the status of your project only after the target date'shown at the top of the page.
,4/though roti should be aontacted'on 0/, by the target date. please feel ree'1o, contact Us_:/ i ou haven't herird /t-0121 us,
hr your target date Staff mar contact von he/'ore the 'target date 'i/'the, initial ievieu is-comp%ete:';Bi following ttrs',
procedure, t'o/ gill save hue anal a1aw the reviewers to complete the work /1101e.etpcditiously.
Steps in the Permit Process
1. Counter Complete.,Your application-has,:bcen accepted., as counter complete., This means -Lill 'Of •the required
documentsis indic itcd 011 OUi Pic Application Checklist Iiai. been submitted, or:fia�c'°been:'.approved for,'deterred
submittal. This docs not prevent technical staff from requesting additional information as a result of their technical rebiew.
2, Quality Check. The nett step in the process is a qualify 'check to 111akc,'sure that=the application is -reviewable and free
from substantive tlaivs that 'sould,prevent technical staff from completing the technical, revteW,once, it is staFted:.'When :•
this step is complete, your application will be' routed' to the';appropriatestaff and 'remain ,tn'thcir review queue until it -'
comes up for review:
3. Technical Compliance. Once an application is administratively,conipletc, it isrtuted to'technical'staff for compliance•
review. Depending on the type of project,' technical staff may. include'nulltiple'reviewers, You, should be contacted,by-•
phone; his. entail, or mail by your TARGET-DATEonce the initial technic it compliance,review is.contplete ,'
d. Permit Issuance. When the technical compliance'revicw of the application is complete, including any,subsequcnt re- -
submittals, each''reviewer will approve their section of the application'and route it to thc•Perniit Center, When'allisections '.;
of the application are received, a•Perntit Specialist will process' the "application and contact, the persotispectlied on 'Our ”
application for permit pick -Up: Information reuardifue fees•and pre-'coristructionmiectibgg (if fequired) will be provided by
the Permit Specialist at.that time. ,
WHITE—APPLICANT PINK—BUILDING FILE REV9/07
Spokane
4.001/2lley
Development Engineering
11707 E Sprague Ave Suite 106 • Spokane Valley WA 99206
509.921.1000 ♦ Fax: 509.921.1008 • cityhall@spokanevalley.org
Approach Permit Application. Review
TO: Building Department
Site Address: 717 S. Moen St.
Project No: 10-2555
Reviewed By:
Date: 0/;//o
Accepted
Not Accepted
Approach
*X
Building Location
Paved Access
Notes: Saw cutting of existing curb is not allowed within the City's
jurisdiction. Driveway is to be inspected by the City's ROW Inspector prior
to concrete placement.
*Approach to be constructed per approved plans on file with the City.
Reviewed By:
Date: 0/;//o
SITE PLAN
SCALE: 1" = 20' - 0"
V
M
sG
6'-0"
61.45' Pao.
,IIN REAR YARD SETBACK LINE
--em4
50'-0"
Z
]aPROPOSED;:
•.4CONCRCTE•.
P.1T10
PROPOSED SINGLE
FAMILY RESIDENC'.
ECE
L
5'+
PROPOSED
CONCRETE
PORCH Sr WALK
LOT 3 BLOCK 2
PRASADA PLACE
SPOKANE VALLEY, '�
WASHINGTON
NO EXISTING OR PROPOSED
ACCESSORY STRUCTURES
AT THIS TIME
ELE
J
Zr,
F n
V Y
—
C F-
F
Q --.G
Vey,
= Q
^ En
[) y
Q
Z'
C
ZQZ Z
Lj
U
iJ_
QFJ
Z
Z
F
-Cz
CiL
Erd
F Q
FpF
v: 5 cr
ysy
y J
—�L
N^ C
2:zz
cQQ
cz
Zc�
Z n F
1Zu
52
E
tr
CSV PFRANIT CENTEei
lln, a¢ plan ',ban mbmirrdlathy oilu
ubomg a!mWn. p my and rt m
,e and carnal
rtprtapam elle propel All YwnPOP
lnednv,mm. nob Lm,..mee.x.nd eam.m,
ba,t been&nu(N Also ma/an-dr'. welarch
FOJin o�vnke anapdo n mother cmie,l arta,
slmn _9,Z< P -/t
Dm. 0-I1-10
717 s. MOEN ST.
BUYER APPROVAL
VIKING APPROVAL
STAmmO Ce e
.lave TN
PRASADA FS SPEC.
Heather Morris
From: Wayne McGavran
Sent: Tuesday, August 24, 2010 11:20 AM
To: Permit Center; Scott Wallace
Subject: RE: APPROACH 10 2555
I approved this approach, today.
Wayne
From: Jodi Main On Behalf Of Permit Center
Sent: Monday, August 23, 2010 7:54 AM
To: Permit Center; Scott Wallace; Wayne McGavran
Subject: APPROACH 10 2555
Thanres :l
Jodi Main, CPT
Permit,5pecialist
City 0FSPOKane Valley
11703E SPrailue, B-3
Svo/cane Val/eYW4 99206
P#509 -72o-5319
Fm'5o9.688-0037
1