2008, 09-22 Permit App: 08003752 ReroofPermit Center
11703E Sprague Ave, Suite B-3
Sp0°Fle•w_ Spokane Valley, WA 99206
4000 Wier (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
SITE ADDRESS:
PERMIT NUMBER: ‘;5--157..-
PERMIT
j52PERMIT FEE . b l 1 S
n Commercial
/a Residential
ASSESSORS PARCEL NO:
Building Owner:
�lZ£C t'J cb
Name:
Address:3,z,2 3 N Z
City i l/woad State: Zip:
Phone:de? _ 030 G Fax 29A,_
as i ,
Contact Person
Name: /yf,4J2,K nvS //1
Phone: a / g' - 6Oo
Describe the scope of work in detail:
Contractor: ... 4.
r"
Name: i rk //At
Address: c;7345,...5—
5 - C c7,-;:s.e/ar/
City: O%i5 0„efeirrikState: Zip:woz7
Phone: oZ /6 _ 6 0O a Fax:
Contractor Lic No: Exp Date:
5c -'S:49941 4A/
City Business Lic. No:
Tear off n Overlay
Cost of project: $ 3 •70'0 ,
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.d- • -nt rights granted by any issued permit inure to the property owner.
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
❑ Check
❑ Mastercard
Date :/..2 /08
❑ VISA
Expires: VIN#:
Effective October 28, 2007
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P:\Community Development\Fonns\Building forms\Reroof Building Permit App.doc