2003, 10-07 Permit App: BLD-03-02709 Re-Roof 2/02
PPR13 2003 16:04 FR TO 534i847 P°2
Cityof Spokane Valley PHONE 009)6611-0036
FAX it ( 09)68
11707 East Sprague Avenue, Suite 106 �ns����-�p,�
58-0031 1
Spokane Valley, WA 99206 PERMIT#
BUILDING PERMIT APPLICATION O 'd.- 90
1
.r J/y'�s T Q11e�o, JOB LOCATION C
Box I OWNER q a�- a 3?3
OWNER'S ADDRESS_ CITY ___ PHONE
/AS/Z i. /ate o [1 -/moo`
PRESCRIBE JOB ,—
THIS PROPERTY 1S OWNED BY:SINGLE/MARRIED
PARTNERSHIP CORP._ ,�� '
'®=-"--.'�-��-� PHONE
game products
BOX2 CONTRACTOR°SNAME_,_SPecialty WA 99202
CONTRACTOR'S ADDRESS 2222 E. Ma 11 on
CITY Spokane,
.--------
11 -09-03
CONTRACTOR'S REG.# S PECIW*0 8 7 JW EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR 2r
BOX I CONTACT PERSON OF PROJECT 114
PHONE
_ CITY ZIP
ADDRESS - ..._—====--gin==--,�1• .._.� `i =lardleti -
BOX 5 ESTIMATE
D PROJECT COST$ _ _ _
EXISTING BLDG.VALUATION�_±�� ..-.-:' ..,----71-:11,7-S2?-2z).00
�¢�
- -- sem= _-��
nor
BOX 8 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
BOX 7 BUILDING SQUARE FOOTAGE(Existing/ proposed) 1ST FLOOR
/____ r+(dLOtaR_ I
3RD FLOOR I
OTHER EASEMENT FINISHED, J______
EASEMENT UNFINISHED_I DECK I-�---GARAGE____1_,
CARPORT ! TOTAL
`-�'� 7C�� '�� r — r HEIGHT TO PEAK OF BUILDINC��_ �
- �p = _� _ _ = t
( ) NEW CONSTRUCTION
BOX 8 ( ) SINGLE FAMILYEXISTING STRUCTURED ate
( ) MULTIFAMILY(NO. OF UNITS �) ( )
( ) COMMERCIAL I INDUSTRIAL TOTAL AREA OF PROPERTY SOa rt.s
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE_
E
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION IAM ON AUTHORIZED BY
BME I RUE A DF THE TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT
ABOVE PREMISES TO PERFORM THE WOR OR WHICH THE APPLICATION IS MADE.
OWNER I AGE
DATE /D' --2-0
I hereby authorize the City of Spokane Volley to charge the fee for this print—Ito my ereatt card: .
Vita Ivlsstercaril A.8562.002k6_161864___ _ — Expiration Date 01 /05
der ` „„ - -- IIli$wahire./"1./...---,--.4110...
Prlbt the UAW of the Hol .... -, .- _ _ -
TOTAL F�Af'E.®2
�1CT a4 PPM 07:20 PAGE.01