2006, 11-29 Permit App: 06004675 ReroofSpokane
,�,1 .Walley
Community Development
Permit Center
11707 E Sprague Ave, Suitej06
Spokane Valley, WA 99206—) `
(509)688-0036 FAX: (509)61 07C IF 1J li
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w w.spokanevallev.org.com E t�
Reroof Construction
Permit Application
SITE ADDRESS `'t l(c;N , C IA LAI . +�
MV 2 9 2006
✓ ti Commercial
U 11 L Rq /Residential
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Name: JZ'rh '7. 6c -P..0
Phone: ci) 22 -9 2
Describe the scope of work in detail:
E
ontiacI or '
Name: J---6 1`k.N . &T'`-P-Lxi )
Address: (-451c., N. C. A. L .j t l& -i'
City: (- Pc:uiF V t4 LLt. Zip: 75'2 /
1 Phone(c) '722 `{m ax: 72 Z - f c Fig
Name: JZ'rh '7. 6c -P..0
Phone: ci) 22 -9 2
Describe the scope of work in detail:
E
ontiacI or '
''''.5' s',.., ti3 ::
Name:
.
OC.,-) APE LAddress:
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
0 Tear off El Overlay
<--)*A-)E-x) SThMy 44 y7z
Cost of project
$ ! S0a 6C
i
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 informatir may be required to be submitted, and subsequently approved before this application can be
processed.
Ownership of resulting evelop t rights granted by any issued permit inure to the property owner.
Signature
Date 1/- 2 C-;
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash Di Check ❑ Mastercard
❑ VISA ❑Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/2312005