2004, 08-16 Permit: BLD-04-07382 Remodel F a
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.0,•' Talley RESIDENTIAL ADDITION/REMODEL PERMIT
11707 E. Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-07382
Job Address: 11205 E 4TH AVE Applied: 08/16/2004
SPOKANE VALLEY WA 99206 Issued: 08/16/2004
Description: REMODEL KITCHEN, REROOF W/2ND LAYER AND REPLACE WINDOWS Expires: 02/12/2005
Subdivision: Lot: Blk: Parcel No: Zoning:
Owner: HULTQUIST, DANIEL D& LYNN
Applicant: HULTQUIST, DANIEL D& LYNN Phone: (509)994-0080
Address: 14516 N FREYA ST
MEAD,WA 99021-8924
Contractor: Phone:
Address: Lic No:
General Information: Fees:
VALUATION 10000 BASIC PERMIT FEE 181.25
REROOF Y WSBCC SURCHARGE 4.50
COST OF PROJECT 10000 TOILETS 12.00
SERVED BY SEPTIC SYSTEM no TUBS 6.00
WELLS LOCATED ON PROPERTY no SHOWERS 6.00
TOILETS 2 SINKS 12.00
TUBS 1 DISHWASHER 6.00
SHOWERS(PER TRAP) 1 CLOTHES WASHER 6.00
SINKS 2 WATER PIPING/DRAIN-IN WASTE 6.00
DISHWASHER 1 WATER USING DEVICE 6.00
CLOTHES WASHER 1 Total Calculated: 245.75
WATER PIPING/DRAIN-IN WASTE 1 Deposits/Receipts: 245.75
WATER USING DEVICE 1
Total Due: 0.00
Disclaimer:
The permitee verifies,acknowledges and agrees by their signature that: 1)If this permit is for construction of 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)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 resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature Date
Staff Initials
THIS IS NOT A RECEIPT