2003, 07-01 Permit App: BLD-03-02017 Garagety of Spokane Valley
707 East Sprague Avenue, Suite 106
)kane Valley, WA 99206
PERMIT #
BUILDING PERMIT APPLICATION
PHONE (.509)688-0036
FAX # (509)688-0037
Box 1 OWNER 4e,h /�d,�,�,' gra 5 JOB LOCATION V 3a2 5 - S ` 71.
OWNER'S ADDRESS 4/3? -g. 5. CITY PHONE (7/66
4,A.$74--•-sirj-
DESCRIBEJOB /9.022 /6 �7e aZG 7)e -¢-!P 6:4A- e. -
THIS
. -
THIS PROPERTY IS OWNED BY: SING
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME /moi+' /e PJ Cam s T PHONE -/6 -39C 7
CONTRACTOR'S ADDRESS 9 i 7 CITY �"�b -.o 4,1)'e -
CONTRACTOR'S REG.#CAMent'C 98'/?J3 EXPIRATION DATE/at o f
(CARD MUST BE PRESENTED AND COPT D O VE IFIED)
BOX 3 CONTACT PERSON OF PROJECT n.it)
ADDRESS 92Gr 7,�,-7.-2•"+,/1v'- - CITY
PHONE ?-/ 6 -_ .39 , 7
ZIP q9,7 -1/g
aZT
BOX 5 ESTIMATED PROJECT COST $ 7�/
EXISTING BLDG. VALUATION $
- -
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAG (Existing
3RD FLOOR / OTHER
BASEMENT UNFINISHED
DECK
CARPORT / TOTAL /
1ST FLOOR /
2ND FLOOR /
BASEMENT FINISHED
/ GARAGI 29 / 4/K
HEIGHT TO PEAK OF BUILDING
FT.
BOX 8 (X) SINGLE FAMILY
( .) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
( ) NEW CONSTRUCTION
(,) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE SQ. FT.
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
kBOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
)WNER/AGENT `S-- DATE 7`, -e>-3
111
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard_ _ _ Expiration Date
Signature
Print the name of the Holder
APPRO
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07/02/2003 JUNCJ 110
1 5093:11.241567
APPRO .ED; 8Y
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TO 3241567 P.01./E-
(,51/0-9
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** TOTAL PAGE.01 **
5093241567 PAGE.01