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2003, Permit: BD03-595 Reroof"d ty of Spokane Valley PHONE (.509)688-0036 1707 East Sprague Avenue, Suite 106 FAX # (509)688-0037 pokane Valley, WA 99206 PERMIT # D 0-S—S-- S"----' BUILDING PERMIT APPLICATION Box 1 OWNER F Imet4A, JOB J-OCATION Ja..51)� ,b+hOWNER'S AESS i 6(Vg" CITY "HONE DESCRIBE JOB ( 'Nes. THIS PROPERTY IS OWNED BY: SINGLE/MARRIED '3.2_ PARTNERSHIP CORP. i te .(QS BOX 2 CONTRACTOR'S NAME 4). PPien ni j4 PHONE WLI-6795 4 'cc) CONTRACTOR'S ADDRESS 2-I ! 1-12001fl CITY A , CONTRACTOR'S REG.# IV W.° q90/1--. EXPIRATION DATE r 13 _O-I (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT AA:0 ferrtiMuj PHONE 9911-G7f.i ADDRESS -- Gi-W — ZIP - • BOX 5 ESTIMATED PROJECT COST$ 194(3(7, ( N EXISTING BLDG. VALUATION $ .. - . -_.. BOX6 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 / 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 PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER/AGENT DATE ` I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Expiration Date Visa Mastercard — _ -- ---- -- i Signature Print the name of the Holder —_ - __ _ _ _ _ _._. __.._ _ ___ - .--- g' a / 9 ice.