2004, 03-22 Permit: BLd-04-03827 Remodel Spokane
.1• 00Valley RESIDENTIAL ADDITION/REMODEL PERMIT
11707 E.Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-03827
Job Address: 10215 E 16TH AVE Applied: 03/22/2004
SPOKANE WA 99212 Issued: 04/05/2004
Description: REMODEL/CONVERT DUPLEX TO SINGLE FAMILY RESIDENCE Expires: 10/02/2004
Subdivision: Lot: Blk: Parcel No: 45204.3830 Zoning:
Owner: SIEGEL, GERALD M&E RIBA
Applicant: SIEGEL,WILLIAM G Phone: (509)922-1961
Address: 10215E 16TH AVE
SPOKANE,WA 99212
Contractor: Phone:
Address: Lic No:
General Information: Fees:
VALUATION 6000 BASIC PERMIT FEE 125.25
REROOF Y DRYER 10.00
DRYER 1 VENTILATING FANS 10.00
VENTILATING FANS 1 TYPE I HOOD 50.00
TYPE I HOOD 1 WSBCC SURCHARGE 4.50
COST OF PROJECT 6000 Total Calculated: 199.75
#OF BEDROOMS 3 Deposits/Receipts: 199.75
OCCUPANCY GROUP r-3
CONSTRUCTION TYPE 5-n Total Due: 0.00
STRUCTURES ON PROPERTY 3
CURRENT PROPERTY SIZE 75 X 150
SERVED BY SEPTIC SYSTEM no
WELLS LOCATED ON PROPERTY no
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.
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Print Name Signature Date
Staff Initials
THIS IS NOT A RECEIPT
/�\ THIS IS NOT A PERMIT
SCITk(Wm I'' ��kaiak Penalties will be assessed for
poISane commencing work without a permit
00 alley RESIDENTIAL ADDITION/REMODEL
11707 E.Sprague Ave., Suite 106
Spokane Valley,WA 99206 Application #: BLD-04-03827
Job Address: 10215 E 16TH AVE Applied: 03/22/2004
SPOKANE WA 99212 Issued: 04/05/2004
Description: REMODEL/CONVERT DUPLEX TO SINGLE FAMILY RESIDENCE Expires: 10/02/2004
Subdivision: Lot: Blk: Parcel No: 45204.3830 Zoning:
Owner: SIEGEL, GERALD M& E RIBA
Applicant: SIEGEL,WILLIAM G Phone: (509)922-1961
Address: 10215E 16TH AVE
SPOKANE,WA 99212
Contractor: Phone:
Address: Lic No:
General Information: Fees:
VALUATION 6000 BASIC PERMIT FEE 125.25
REROOF Y DRYER 10.00
DRYER 1 VENTILATING FANS 10.00
VENTILATING FANS 1 TYPE I HOOD 50.00
TYPE I HOOD 1 WSBCC SURCHARGE 4.50
COST OF PROJECT 6000 Total Calculated: 199.75
#OF BEDROOMS 3 Deposits/Receipts: 0.00
OCCUPANCY GROUP r-3
CONSTRUCTION TYPE 5-n Total Due: 199.75
STRUCTURES ON PROPERTY 3
CURRENT PROPERTY SIZE 75 X 150
SERVED BY SEPTIC SYSTEM no
WELLS LOCATED ON PROPERTY no
THIS IS NOT A RECEIPT