2015, 03-09 Permit App: BLD-2015-0421 Demo Structure 03/09/2015 MON 10:39 FAX ?005/
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Project # EL:P--i-xls--L1-0-
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Community Development Department "
Permit Center 4J D
SiffOPlia#81111 11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER: X11
� ie Spokane Valley,WA 99206 , ` �4 �
Tel: (509) 720-5240 PERMIT F .
Ya Fax: (509) 688-0037
permItcenterasookanevalley_orq CSV PERMIT CENTER
PERMIT APPLI6O1 IoN-�- i `'Ev. '_r---------
DEMOLITION
PROJECT ADDRESS: 51g2 Al £, N44•'�,c� IAr* 9 9 zi 2,
ASSESSORS PARCEL NO.: ....j.5"a3/,
BUILDING OWNER NAME:11/41QJ/'f inihni 7"rr tpof-fakio - EctSfzen Div.
MAILING ADDRESS:p , \ V i ,. if/ ` =d I A I� /�
CITY: Sp0 rRE1 C STATE: W . Z&P: q q A Y 7
CONTACT PERSON NAME: IVa 6 G QL,P-t r i di e
PHONE: 5 d ' - .3... - . I FAX: r • — , - . 6 6 CELL: n _
CONTRACTOR NAME: Nal JJAin, ceh Phi fro Airty enJ Eypik,rrizkey,,rn4.-
MAILING ADDRESS: 6 05- x17.5 t r r Rae of
CIN: W0,VAL. ?AIWA STATE: /10* ZIP: 4 914 2.
PHONE: 37311-52T- 72 O 3 FAX: 5O L +ff q* 013 4 2- CELL: /t i b
CONTRACTOR LICENSE No.: {{4tI YJ p et35flK EXPIRES: III AO I(p CITY BUSINESS LICENSE NO.:
P• •JECT DESCRIPTION (Please Provide Site Sketch
n Site Plan Provided F Notice of Intent# I r-6 a 1I-
V Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
4 „0„.„4...,__(4 ___
DIMER
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 Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal,state or local laws,codes or ordinances. 6) Plans or additional
Information may be lured to be subml d and ubsequently approved before this application can be processed.
Signature (AA Date: .3/9/a0(6—*
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Updated 1-11-11 Page 1 of 1
C:\Users\H.J. Excavation1Documents\Pmjects\2015-WSDOT NSC 2015 Demo No 1\Demo_Permit.doc •
Received Time Mar. 9. 2015 9: 08AM No. 1566
03/16/2015 MON 11:39 FAX 011/011
2015-0088 -
Page l of I
2015-0088 . '�"-� -
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