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2006, 06-30 Permit App: 06002566 Tear Off, Reroofr Permit Center S okane 11707 E Sprague Ave, Suite 106 Valle Y Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Cornmunity Development a ww.spokanevailev nre.com Reroof Construction Permit Application • PERMIIINUNIBE (p PERIvIITFEE- leb b •>,^r r:' ❑ Commercial ❑ Residential SITE ADDRESS /D 5 E. rEigi-1ZL,(n I' ASSESSORS PARCEL NO: LEGAL DESCRIPTION: Bnil`di g owner';;`LT .9-. ._ 9 Name' j/ VVI Pm i F-.)D1� Address:/Q/9/C i` . �y�R7--- aD� City: sr),D Il JA L I Ey Zip: Phone: Fax: ontact€P.erson _ }_„ Name: Ctyi V FA1�R13� JS Phone: 1107- Ss -7, Describe the scope of work in detail: Contractor Name: C r,rAa ?DOE"'Ai e Address: 14/07 `-91(2/us AV Is- City:spo,t- WA Zip: 9 2.17 5— lac Phone: 4% 7- On Lic No: CAST Agit" 03 1Exp Date: City Business Lic No: Tear off 0 Overlay Cost of project // 9.93°-c-1- DISCLAIMER 9UOo 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 information may be required to be submitted, and subsequently approved before this application can be processed. Ownership of rting developights granted by any issued permit inure to the property owner. Signature / a-- Date aj,3Qloco Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: REVISED 8232005