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1004, 03-23 Permit: BLD-04-03860 RemodelSpokane .000Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: RESIDENTIAL ADDITION/REMODEL PERMIT 847 E SHELLEY LAKE LN VERADALE WA 99037 FINISH BASEMENT - (3)BEDROOMS, (2)BATHROOMS & REC ROOM GEORGE H WHITE INC //(j .( Permit #: BLD -04-03860 Applied: Issued: Expires: Lot: Blk: Parcel No: 45241.2605 Zoning: HERSEY, PAUL Phone: (509) 928-4797 14314 E 6TH AVE SUITE B SPOKANE VALLEY, WA 99216-2113 HERSEY, APUL 14314 E 6TH AVE SUITE B SPOKANE VALLEY WA 99216-2113 Phone: Lic No: (509) 928-4797 HERSEP*984P8 03/23/2004 03/23/2004 09/19/2004 General Information: VALUATION REROOF COST OF PROJECT SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS URINALS TUBS SINKS 7500 Y 7500 no no 2 1 1 3 Fees: BASIC PERMIT FEE WSBCC SURCHARGE TOILETS URINALS TUBS SINKS Total Calculated: Deposits/Receipts: Total Due: 153.25 4.50 12.00 6.00 6.00 18.00 199.75 199.75 0.00 Disclaimer: The permitee verifies, acknowledges and agrees by their signature that: 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. Ownership of resulting development rights granted by any issued pit inure to a ro erty owner. l Her—se (i Print Name / Signature Staff Initials THIS IS NOT A RECEIPT .3 -z3-rf Date