2013, 09-16 Permit App: BLD-2013-1866 Inspect 14/��1/ r v t - Uva
Community Development Department (Staff Use Only)
Permit Center
11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Scelan Ora Spokane Valley, WA 99206
�P0 ne Tel: (509) 688-0036 PERMIT FEE:
�,40000 Valle
y# Fax: (509) 688-0037
permitcenter@spokanevalley.orq
COMMERCIAL (NON-RESIDENTIAL) CONSTRUCTION PERMIT APPLICATION
igi NEW CONSTRUCTION N TENANT IMP OVEMENT OTHER
SITE ADDRESS: ASI N , 5GCh q lL
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
MAILING ADDRESS: - I V 3 . t 5a-rge � d
CITY: `i `/ STATE: V 4 ZIP: C19-2--`Z.
CONTACT PERSON NAME: vhev' L a_'m
VVV
PHONE: O°1 61`l aGi ' (cl FAX: CELL: —9119'
CONTRACTOR NAME:
MAILING ADDRESS:
CITY: STATE: ZIP:.
PHONE: • FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: '
ARCHITECT/COMPANY NAME: .
MAILING ADDRESS:
CITY: STATE: ZIP: ,--c)--- L/ f 2_( ga
PHONE: FAX: CELL:
NAME OF OCCUPANT OF STRUCTURE:
PHONE: --afrie\_,Q. FAX: CELL:
CONTACT PERSON NAME:
PHONE: FAX: CELL:
DESCRIBE THE SCOPE OF WORK IN DETAIL
A- Lc, f n_e_ ( r)(1 (67697(
TYPE OF PROJECT: TOTAL BUILDING SQ FT:
HEAT SOURCE: FIRE SPRINKLERS:
PRIMARY OCCUPANCY: SQ FOOTAGE:
SECONDARY OCCUPANCY: SQ FOOTAGE:
TOTAL COST OF PROJECT: $
DISCLAIMER
The permitted verifies,acknowledges and agrees by their signature that: 1) if this permit is for construction 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 Devel.5 ent e. Referenced codes ar..,available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley per- it is not a p rmit or approval for any(v olation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may •- required to b su. , itted ands sequ Jy approved before this application can be processed.
Signature 0 Date: Cr/q., 13
I Cr i�-
Updated 1-10-2011 Page 1 of 1
CITY OF SPOKANE VA Y
BUILDING DEP .
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PERMIT NUMBER -e)l-t. 0 ' )-•'N,1
144L C ADDRESS 25 .-1 n
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OWNER 7 .
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DATE SUBMI r ED DATEAPPROVED
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