2008, 07-11 Permit App: 08002687 ReroofPermit Center
Sfilik �V a 11703 E Sprague Ave, Suite B-3
ll`ll7 Spokane Valley, WA 99206
iF Valley (509)688-0036 FAX: (509)688-0037
www. spokaneval1 ey. org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: S-a(p 3-1
PERMIT FEE: 15�
n Commercial
Residential
SITE ADDRESS: a"1W /tie mg -0 Sp0/LaUr dam 04
ASSESSORS PARCEL NO:
Building Owner: - - -
Contractor: )_ [
Name: aNriat ( /`bo'r'16 LLL
Address: 10 0
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Name:/yl/%'/o, / 9f /6M if' ( &pet,
Addressss:�029I 0 V v noun
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City: 5 � D -. State: /; /A Zip:
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City: 5,640E State: am Zip:VG G 09
Phone: 99y c{5t,y Fax:
Phone: 9G.q ._ 3sp Fax:
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Contractor7Lic7No: v .cg/ y ,Exp Date:
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Contact Person-__- - - - --
City Business Lic. No:
Name:C:10SP k 6E (016OPq
Phone: q7y -Licit(
Describe the scope of work in detail:
NEO) ,3 o yecat (4/ (ei
Frear off ❑ Overlay
Cost of project: $ ((00
The perrnitee 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 re.ulting develo• -nt rights granted by any issued permit inure to the property owner.
Signature
Metho r of Payment:
❑ Cash Ett Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Date 97(//C ti
Effective October 28, 2007
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