2005, 05-02 Permit Application: 05001388 Tear Off, ReroofCITY OF SPOKANE VALLEY
BUILDING PERMIT APPLICATION
11707 E. Sprague -Ave. Suite 106
Spokane Valley, WA 99206
(509) 921 -1000 or 688 -0036 Fax (509) 688 -0037
OWNER
JOB LOCATION
OWNER'S ADDRESS gg CITY PHONE
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORP
CONTRACTOR: BENNETT ROOFING
ADDRESS: 3318 N STONE
CONTRACTOR'S REG. # BENNER994MQ EXP. DATE 07/17/2005
CITY Spokane
STATE WA
ZIP 99207 PHONE: 4831873
CONTACT PERSON LARRY BENNETT
ADDRESS 3318 N. STONE
CITY SPOKANE
PHONE 939 -5191
ZIP 99207
ESTIMATED PROJECT COST$ 3/Q D, d 0 EXISTING BLDG. VALUATION $
( ) SINGLE FAMILY
( ) MULITFAMILY (NO. OF UNITS )
( ) NEW CONSTRUCTION
( ) EXISTING CONSTRUCTION
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMNATION 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 PREMSISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT
DATE
1 hereby authorized the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard Expiration date:
Print the name of the Holder Signature