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2008, 09-08 Permit App: 08003532 Tear Off, ReroofPermit Center Spokane ` 11703 E Sprague Ave, Suite B-3 j Valley Spokane V-0 36 WA 99206 (509) (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Community Development Reroof Construction Permit Application p �C SITE ADDRESS: l g ASSESSORS PARCEL NO: PERMIT NUMBER: .S-3"?..„, PERMIT FEE S - n Commercial Residential Building Owner: Name: Name:WW)(6t5_%D1,\ 40\ Address: ,,,, �J� )9Sio (( ��� rf, a , © / _I City: r"" U C tate: c �_, v Zip: Phone: ax: ' , Contact Person Name: D6- F Phone: Contractor: Name:WW)(6t5_%D1,\ 40\ �y '� -Address: ��� rf, a , © / _I City: t State: Zip: ' , Phone: ,6;?l 4 //K 4/O // Fax: Contractor Lic No: n C ,E, Date: City Business Lic. No: Describe the scope o ork in detail: Tear off .6* //4-r c5 Overlay Cost of project: $ 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. Ownership of resulting development rights granted by any issued permit inure to the property owner. Signature Method of Payment: ❑ Cash Bankcard #: Authorized Signature: ❑ Check Date ❑ Mastercard prQ_/1_,SA VIN#: Effective October 28, 2007 Page 1 of 1 P:\Community Development\Building Division\Jodi-comm'l\PCF\Reroof Building Permit App.doc