2007, 10-19 Permit App: 07004246 Tear Off, ReroofSp®k nae
Dalley
Community Development
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Permit Center
I 1 703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)68R-0036 FAX (509)688-0037
www.spokaneval Iey.ore
Reroof Construction
Permit Application
PERMIT NUMBER. 42462
PERMIT FEE: /42(<77:5----
Commercial
a(<7_
Commercial
Residential
SITE ADDRESS- a7'.2/ S CIS/
ASSESSORS PARCEL NO:
Building Owner:
Contractor:
Name.
Nance.a14/
Address:
Address: J7 ,g 5-77
City State: Zip:
City. Y nt.E.. State• / ,4 Zip. 3,
Phony Fax:
Phone: D/ i�I .2 g Fax: /j/��'r_U/37
Contractor L(ac acto::LL/,CLPjgJ [xp Date:teeigAt
/n
Contact Person
City Business Lie. No:
��75/S7Z
Name 2%[I/�7Vr:
Phone fT/1-G339
Describe the scope of work in detail:
Tear off
• Overlay
Cost of project: $ 3goo
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 development rights . -nted b issued permit inure to the property owner.
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Signature/ � � Date 7° '—/P &7
Metho. of'"Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 812312005 -
Check
❑ Mastercard
Expires:
❑ VISA
VIN#: