2003, 04-09 Permit App: BD03-060 Garage City of Spokane Valley PHONE (509)688-0036
L1707 Eat Sprague Avenue, Suite 106 FAX # (509)688-0037
;pokane Valley, WA 99206
PERMIT # 60
BUILDING PERMIT APPLICATION
Box 1 OWNER '<et Fd t-,14 JOB LOCATION 10, 13 (Z Ii; I stir
OWNER'S ADDRESS N.1312 j4;jbw„- CITY okav-=-PHONE 236-Z3 Yo
DESCRIBE JOB Po B�, lC�`tv�- �jc��.r- C ( LI x(40
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME rxcw1;bk.(Slee(,Sif'g` cyte,. PHONE 9z/. /3&'
CONTRACTOR'S ADDRESS P.a . / CITY 5'/90�CONTRACTOR'S REG.#FX( 4L— QoOCv EXPIRATION DATE — 2 —d`c
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT _p --( >70'
wwe1 PHONE 12/ - /1500
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ADDRESS RO , rJ O X 1't ( CITY ,gip v k-e1 4-e- ZIP 9 -2-/
BOX 5 ESTIMATED PROJECT COST$ EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR / 2ND FLOOR
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED / DECK / GARAGE q
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(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 P •RM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT � DATE " _t9 3
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I hereby authorize the City of Spokane Valley to char the fee for this permit to my credit card:
Visa Mastercard —__ Expiration Date
Print the name of the Holder Signature
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APPROVED
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