2003, 07-14 Permit: BD03-789 Reroof JUN 14 2003 16 22 FR TO 7472967 P.01/01
;ity of Spokane Valley PHONE (509)688-0036
1707 East Sprague Avenue, Suite 106 FAX # (509)688-0037
pokane Valley, WA 99206
PERMIT# 3 D 0-3
BUILDING PERMIT APPLICATION
Box 1 OWNER/h k1Nf Te-rts.�:1 JOB LOCATION 42 .0 6 G` L✓6L(/
OWNER'S ADDRESS CITY.. 4fte PHONE 4,27-cam y V?
DESCRIBE JOB ` LOA°-. '/ - %1 , A • )SA 1i _ tgE►
THIS PROPERTY IS OWNED BY:SINGLE(
PARTNERSHIP, CORP.
BOX 2 CONTRACTOR'S NAME ' v. �� � . .'HONE /� //
/(f44C''''n7,1C A:C //.�5 s
CONTRACTOR'S ADDRESS W 73/1 Poli.00ad CITY . -- .
CONTRACTOR'S REG.# 9evii SJ'IO13 L EXPIRATION DATE /'/3(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT (.4)/4m y' 0/9-0,fr y, // PHONE C 2r/
ADDRESS 3 C^ CITY e�ec---xe ZIP 99,2
BOX 5 ESTIMATED PROJECT COST$ (2_756.66— EXISTING BLDG.VALUATION$ / ,,,QQQl9t'
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAG �Fxisfin proposed) 1ST FLOOR %D?G, 2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED /
. �5
BASEMENT UNFINISHED / DECK / GARAGE / L .5 D
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT. 1 •� 7 S
BOX 8SINGLE FAMILY ( ) NEW CONSTRUCTION
((KMULTIFAMILY(NO.OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE_ SQ.FT.
I 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
ABOVE PREMISES TO PERFORM THE WORK FO WHICH THE APPLICATION IS MADE.
OWNER I AGENT `-'w u ��-+�2�� P DATE t7// 7/
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: ,
Vies Mastercard _ _ ,_ Expiration Date
Print the name of the Holder Signalize
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