2004, 08-05 Permit App BLD-04-07271 Re-RoofStreet Address:
To 534VAJI
BUILDING PERMIt APPLICAtION Wdftdfll tt
C;ry of Spokend valley community lwdilbpHimf %AJ��Ntf 01
ailding blvlkldn
11707 5. sproyO AvWk Salt§ 106
Spnkdnd VA116y, WA P9206
Phone: (549) 660-006; PDX: (600) $86-0631
-Lnspe° &!C)n (Ost-0 754
REQUIRED SITE INFORMATION
AAaess'
U1 .3 P --'
�r
LltIgal Desctiptlon-
OLWIT bESC111P
4 �uildlrtg permit
kelol;ati0h
❑ Change in Use Grading MenufAt+106d Ndthd
❑ Tenant Improvement H Flrt- Safety
H other
OWNEWAPPLICANT INFORMATION
❑ owner. ❑
Phone: Fa)c
Address:
Ch1+ ttnta zip Code
Cdntmetor: Specialty Home Products ❑
Phone: 534-8372 Fax: 532-1847
Address: 2222 E Mallon
Spokane, WA 99202
city Stale Zip Code
Applicant:
Phone: Fdc /
Address:
Ck ti't9ta cdde
Architect:
Phone: Fax:
Address:
CRy t3tnle ZO 0
WA State Contractor Llcense #:' SPECIHPO11KS Contact: MASK
1.
PERMITAWILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS;
—t OF STORIES:
MAt FLO TQ 5Q. FTQ:
2 FLOOR SO. FTG:
UNFIN bAS9MENT FTQ
FINISHED BASEMENT 5Q FFG:
GARAGE 8Q, FTC3:
UECKIGOV. PA O 6Q. ;
UPANCY OUP:
CONSTRUCTION TYPE:
HMT SOURCE:
0 OF BEDROOMS:
TOTAL_ HABITABLE SPACE:
IMPERVIOUS RFAC
COST OF PROJECT:
DO, 03
30% SLOPES ON PROPERTY:
SEWER OR ON�WS C
SYSTr=m?
NOW of Paymeht: (Faxed permit•epplicatlons will only be accepted with rrtdfor bankcdid)
❑ Cash ❑ Check [] Mastercard dVISA 0 61h6t
tlanktard #:
Authorized Signal,,
AUG 04 2004 06:3?
This dncumegL o4&aly..-._Gsuliained
confident iar cre`dd card information which
Was rg�actPd.pucsuant to RCVV-19-466X10
and the original Vdocument desT troyea
pursuant to SOS DAN GS2014-030.
Explros:��D�c VIN#: 7e� o . ,,� •,'.
TED
PAGE. 01