2006, 08-07 Permit App: 06003092 ReroofSri, Permit Center
okane 11707 E Sprague Ave, Suite 106
4.0.0 Valley Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
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Reroof Construction
Permit Application
SITE ADDRESS /1/ 924Z 2 `7 t� 4 yuLAA
ASSESSORS PARCEL NO:
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❑ Commercial
Residential
LEGAL DESCRIPTION:
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Name: V,.�t'/ "t- i 410-eVrSCC�
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Address: / 17/ 9O3 t3 c...tA v €y
City:
Phone:
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Fax:
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Name:
Phone:
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Name:
Address:
City:
Zip:
Phone: Fax:
Lic No: Exp. Date:
City Business Lic No:
Describe the scope of work in detail: XTear off
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❑ Overlay
Cost of project
756 . DC
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. 6) Plans or
additional information may be required to be submitted, and subsequently approved before this application can be
processed.
Ownershi
Signature
ting development rights granted by any issued permit inure to the property owner.
Date —
Method o Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
Mastercard ❑ VISA ❑ Other
Expires: 67/e g- VIN #: