2010, 07-19 Permit App: 10002148 ReroofRECEIVED 07/19/2010 08:49 5096880037
07%19/2010 08:49 FAX
SV PERMIT CENTERFR
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art rF � Perit Center
r 117 3 East Sprague Avenue, Suite B-3
Spo ane Valley, WA 99206
-.'•`" �/+, ]� ie x Tei: (509) 688-0036
�F "� Fax: (509) 688-0037
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PERMIT NUMBER:
PERMIT FEE:
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REROOF CON TRLJCTION PERMIT APPLICATION
: COMMERCIALtt ,,
SITE ADDRESS: / � O ,
RESIDENTIAL
ASSESSORS PARCEL NO.: r?5. / LEGAL 6 ESCRIPTION:
BUILDING OWNER NAME: / - /Y7 * c / e U
NAME: &r 17) -_ ' all
CITY: Sep E \ity1-L�`i
ADDRESS: /lac /0 6/a kid_
CITY: Dc")f
STATE: 1/6
ZIP: ! 9.c:314.)
PHONE: /r-16- ~ 106(
okane
\IFAX: CELL:
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: mCVAY
fi:V..011AUS
MAILING ADDRESS: 111-17.0 E mofr,
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CITY: Sep E \ity1-L�`i
STATE: WA ZIP: CA1,0lj
FAX: -C124-7570S ! 0 CELL:
PHONE: 5'1— I12Y6 -1-16S6
CONTRACTOR LICENSE No.: VNGrA1 f7..3i UI m, EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE iTHE SCOPE OF WORK iN DETAIL AND INDICATE USE:
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- • TAL COST OF PROJECT: $ �j
/ Overlay
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DISCLAIMER
heir signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
tty of Spokane Valley permit inure to the property owner. 3) The signatory Is the property
in this transaction. 4) All construction is to be done in full compliance with the City of
The permitted verifies, acknowledges and agrees by
be served by potable water. 2) Ownership of thls C
owner or has perrpisslon to represent the property oS55vvvner
S V if D I
p a ey eve opmerrt code. Refnreu��d co es are available for review at the City of Spokane valley Permit Center. .J Ttte Cf
iiy o
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 su sequently approved before this application can be processed.
Signature
Date:
Method of payment: 0 Cash
Bankcard #:
Check
Visa 0 MasterCard
EXP VIN#:
Authorized Signature: '_VY
Effective October 28, 2007 Page 1 of 1
http://www.spokanevailey.org/uploads/Comunity_Development/Documents/Forms/Building/Reroof Construction Permit
App.l.doc