2003, 08-05 Permit App: BD03-891 Tear Off, Reroof 08/04/2003 06:24 15098929717 HEMENWAY ROOFING PAGE 01
APR 19 20B3 16;57 FR TO H92 x717
Ch:y 6PC 3 - °I I
SPOKANE VALLEY
PERMIT#
BUILDING PERMIT APPLICATION
Box ) OWNER i r,!/ 4r _. JOB LOCA I� 1. 2.
OWNE ADQFt :„�'• tTY T `•pHON�
Dt:scleatl:.Ivl� Q � 3 `f\Sat h Y-itaJ"
THIS PROPERTY IS OWNED HY:SINGLE/MARRIED X
PARTNERSHIP CORP.__
BOX 2 CONTRACTORS NAME I..:%A .* _ ! a mss•r�=�==„ra--- .-- �...ams—=ter
ter.. 'w PHON -131
CONTRACTOR"ADDRE� ‘ .31,a' ' �i - � ► ,CIT WA tL 3(ct
CoAlTMCToke Affe 7-EXPIRATION DAT! - 03
( MUST PRESENTED AND COPIED 04 ARMED)
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BOX S CONTACT PIERSON OF PROJECT, [ rr�r
W� PHONE \^ 10-1-1-1
ADDRESS -, £ 4 tP 2 CITY _ V ^__ZIP
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SOX 4 SEWER AVAILABILITY_ _ Ea- _ WATER AVAILABILITY _
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SOX 6 ESTIMATED PROJECT COST S EXISTING BLDG,VALUATION
N ■ ■■r11.lYk = Jamas==T =�:4.pkta I*. ==,.= Ylrillc==_iii
BOX d PROPERTY TAX ACCOUNT NUMBER Q;• t�
LEGAL DESCRIPTION v ��
•
(IF NECESSARY,PLEAss SUBMIT A SEPARATE PACE WITH THE LEGAL DESCRIPTION)
CeNSUS NLelees —iOT MUM5a11
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BOX 7 BUILDING SQUARE FOOTAGE(F,xistfrrp/proposed) 15T FLOOR_ / 2ND FLOOR /
SRD FLOOR! OTHER / SASEMENT FINISMED
tAHEMF_NT UNFINISHED _--. / DECK f GARAGE /
CARPORT fTOTAL / HEIGHT TC PEAK OF BUILDING FT.
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110X a (. SINGLE FAMILY ( ) HEW CONSTRUCTION
( ) MULTIFAMILY(NO.OF UNITS_ ) (-k ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PRQPERTY SO FT
( ) TENANT IMPROVEMtSNT IMPERVIOUS SURFACE- 60.FT.
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SOX S PLUMBING F•LXTIJREA(lnoluOlfg rough-;n*) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED e'LUMSING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS,HEATING AND AIR UNITS,FIREPLACE INSERTS,WATER HEATERS,CONVERSION BURNERS.
LAWN SPRINKLER SYSTEMS,BACK FLOW PREVENTERS,ET AL.
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SOX 10 Waiter Slavic.*moles WM Or known) - Also see BOX 4
SOX i T SwptI@'rink-Not generally snows°in the City of Spokane VaNry.For gprp181 oroumeterl°Sa contact
Tour*Omer prwrwypr and the HOalth Uletrlot (See BOX 4)
BOX 12 street toe may reoulre e•Street Use Pierer for a*+wr,water,*Idew#lks,;via arts.Contact the PM0h0
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT 714!INFORMATION FURNISHED 5Y ME IS TRUE AND
CORRECT TO THE HST OF MY KNOWLS0G0 AND F LJRDHER i HAT I AM AUTHORIZED SY THE OWNER OF THE
MOVE PREMISES T•P • •EM THE WOFOR WHICH TilE APPLICATION IS MADE.
OWNER/AG .•/f/. /Ir_ rm%�/;41( ../�`,e UATB__n/C-7 (OVER)
RECEIVED
AUG 042003
City of Spokane Valley
08/04/2003 06:24 15098929717 HEMENWAY ROOFING PAGE 02
— This document originally contained
aow 19 a gn. ,Lp°ss FP " co •en la cre.i car. In
ormation which
was redacterrpSi nt to RCW 19.255.010
and the original document destroyed
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move- SETBACKS: FRONT
_SIDE - REAR^ HEIGHT Clot
MANNING DSPARTMSN1-APPROVAL
REMAIRIC' "-�. _.-.'�.,._�draA►Ppoyyti,,,` _, DATE
SEPIA: EXEMPT
SEPIA: EXEMPT _NOT EXEMPT
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LURE DEPARTMENT APPROVAL
•-.....` ,.,,,DIIMJIPMLIVAL._--,- DATS_
REMARKS
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PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL _
-__ DATE
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TYPE OP JOS: NEW RESIDENCE—RES.ADD/ALT- NEW INDUSTRIAL IND-ADD/AIT
NEW COMMERCIAL,_____ COMM.ALTrADD NEW MULTIFAMILY
NO.UNITS
MULTIFAMILY ADQ/ALT__.-.,._—.TENANT IMP. ROOF OTHER . -...._
OCCUPANCY TYPE OF CONSTRUCTION_-. _STORIES
SUILDINO SQ.FT.
--�----- .. __BUILDING SO.FT �.� • rf
BUILDING SQ.IT. a �-- •. - •,.
BUILDING Q.FT, - _
TOTAL.SQ,FT. - TOTAL VALUATION
LIU/LD1NQ PERMIT NO. PLAN CHECK PEE 1;EC'D RECEIPT NUMBER
PERMIT FEE.. PLAN CROOK FEE PLUMBING FEE „MECM.FEE
TOTAL FESS WAC SURCHARGE = ENERGY SURCHARGE_
CYPHER CHARGES _AMOUNT DUI!
•
BUILDING DEPARTMENT APPROVAL BY
DATE
A: lQNED ADDRESS
+M rn'r'gL PAUE.02 -.•.
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