2012, 03-02 Permit App: BLD-2012-0096 ReroofPermit Center
Spliane 11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
4000Valley- (509)688-0036 FAX (509)688-0037
www.spokaneval ley.org
Community Development
Reroof Construction
Permit Application
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PERMIT NUMBER:
PERMIT FEE: 5 -
Commercial
15—C Residential
SITE ADDRESS: 0 AP AOLOOL£i.Seolicave Vait y ci a_D(p
ASSESSORS PARCEL NO:
Building Owner:
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Name: ..-•- h._ 0
..cie
Address'/2 / • A) . .7o (&4
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Phone: 99:5%, 4.---7,76 F :
Contact Pe
Name:
Phone:
oree4-12,‘
Describe the scope of work in detnil:
,e=r7r.
cejear off ri 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 *able 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) Alf 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:
REV1SED £1123/2005
Check
1,•d CZ8Z3817609
Mastercard
Expires:
Date
VISA
VIN#:
>inn SIJJOIA1 d00:7(1 71 7
Contractor: .. ._ .
Morris Clark Siding Be Roofing
Name: 2728 E. Garland
Spokane, WA 99207
Address: 482-28.33
City: State: Zip:
Phone: ,(;2 _Q2 op?? Fax:.7:4.7_,..5-:=2 722
Contractor Lic No: Exp Date:
TY1 6: ge, I eS0 Ca:.2-leA
City Business Lic. No:
cejear off ri 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 *able 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) Alf 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:
REV1SED £1123/2005
Check
1,•d CZ8Z3817609
Mastercard
Expires:
Date
VISA
VIN#:
>inn SIJJOIA1 d00:7(1 71 7