2007, 10-22 Permit App: 07004167 Fire Damage RepairSpokane
_Valley.
Community Development
Demolition
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane ;
Valley, " BY
(509)688-0036.1ALLEY
v, -v, w.spokanC} ,.
Permit Application I3Y.
OC1 17 2001
PERMI ENTER
PERMIT NUMBER: t-4 (01
PERMIT FEE: _4 O
n Commercial
Residential
SITE ADDRESS: 30 1 Ai S b C. -a OrVs-
-
ASSESSORS PARCEL NO:
Building Owner:
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Name: 'T' r -t �Nl c -i` e l< ¶1`(. chi S '-
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Address: go sa cy r0C�
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Name: Fie hack(7/%2,,DcA-C k
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CriaNc�tlobL64 q 3614c1 Exp Date j9� /01
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Address: 30/g, sick. P N
City:5po i (cx State:
Zip:grfc6,
Phone ,3 5_. LiU 5_6,, Fax:
Contact Person
Name: f2� c9- i 6 100_1
Phone: g} - -]0 (/ - � 5
Contractor:
^- ,fibr
Name: 'T' r -t �Nl c -i` e l< ¶1`(. chi S '-
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Address: go sa cy r0C�
City: ectAarld, State: 4...b Zip:s3iss
Phone: 6657-(43q . Fax: $_ 772;2-7 0 E,,,! I
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CriaNc�tlobL64 q 3614c1 Exp Date j9� /01
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City Business Lic. No:
Describe the scope of wo in detail
a PO -1- A\ -6N. o E c..L\ck a - 5y 5 4em1
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 resul ' g .-velopi
k
Signature
ent rights granted by any issued permit inure to the property owner.
Date k) 17 /3-)
Method of Payment:
❑ Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07