2009, 08-05 Permit App: 09002415 ReroofSi�1".000-Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter(@spokanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL
SITE ADDRESS:4607 N CONKLIN ROAD
RESIDENTIAL
ASSESSORS PARCEL NO.: 41.50/1, Q$C3LEGAL DESCRIPTION:
BUILDING OWNER NAME:RONALD & CARLA THURLOW
NAME:
RONALD H THURLOW
ADDRESs:4607 N CONKLIN ROAD
CITY:SPOKANE VALLEY
STATE:WA ZIp:99216
PHONE:509-924-6854 FAX: CELL:
CONTACT NAME:RONALD H THURLOW
PHONE:326-5850
FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DET IL AND INDICATE USE:
COVER CURRENT ROOFING WITH 30YEAR ROOFING Lzwv\PCS n)
Tear Off
TOTAL COST OF PROJECT: $2800.00
Overlay
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The 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.
Signature ,� Q #44, *Like' �. Date: "6 (—'t%
Method of payment: ❑ Cash 0 Check
Bankcard #:
❑ Visa
EXP:
0 Mastercard
VIN#:
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Reroof Construction Permit
App.l.doc