2007, 05-02 Permit App: 07001575 Remove Barn Permit Center Sc
1TY or 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: i ;>
poI dne Spokane Valley,WA 99206 TS-
PERMIT FEE: ( , C(�
fValley. (509)688-0036 FAX:(509)688-0037
www.spokanevalley.org
Community Development
Demolition n Commercial
Permit Application �v�2esidential
SITE ADDRESS: 5J 6 t, ir/E f //1y
ASSESSORS PARCEL NO:
Building Owner: Contractor:
Name: )D 1,1141-f7 j fool-57/1,1 Name:
Address:95 11 1 E N 1 1, Address:
City: /'n, fMr V Y1'�,,, State:WH
Zip:q ,, City: State: Zip:
Phone:50,7_ w �y� Fax: Phone: Fax:
Contractor Lic No: Exp Date:
Contact Person City Business Lic.No:
Name:
Phone:
Describe the scope of work in detail
��tlrr ��wN ol-i /3/Pei
o A site plan is provided.
o Spokane County Utilities has approved the disconnection.
o Notice of Intent #
The permittee verifies, acknowledges and agrees by their signature that: 1)Ownership of this City of Spokane Valley
Permit inure to the property owner. 2) The signatory is the property owner or has permission to represent the property
owner in this transaction. 3) All construction is to be done in full compliance with the City of Spokane Valley
Development Code. 4) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances.
Ownership of result' development rights granted by any issued permit inure to the property owner.
Signature,/P" c`��l U 1 % ,� ��/ j Date
Method of Payment:
❑ Cash E4heck ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07
2