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2010, 06-01 Permit App: 10001568 Tear Off, ReroofPermit center 11703E Sprague Ave, Suite B-3 ��®y PERMIT NUMBER: (� �� [j a Spokane Valley, WA 99206 va11cy. Cs- PERMIT F �� 1 (509)688-0036 FAX: (509)688-0037 www. s pok an e va l l ey. org Community Development Reroof Construction Permit Application ❑ Commercial Residential / � s1=PE ADDRESS: / / Q/25 t rc iv 2_ , Liy ill ' et qct ZE* ASSESSORS PARCEL NO: BuildingOwner: "" `` - - - ;',..,,. ,..{�l� Contractor J,, ' - _; - _- __ �(�C"��P�}!/���'c.' '"' ': // Name: �/,'/ e /J O S�GI, Name: J/�'f/jP Address: // q 2� (� �z/. Address: a( c ©o l -7.2a-(/ [� City: LJ��� State: / � '1 A Zip -19706p 6p (X//f t/ Zip: qqz 2 City: G' State: ,W4 / Phone: Fax: Phone: / i�'_.,Qtpo i Fax: 5-36 75 /7i O act?! Cot-tContractor fU(bio: Exp Date: c / 2 f�/9- l t�G'( 70 Contact Persppon 1 '1'' City Business Lic. No:/t/1i e s, £r,' zctLCt7 & (tName: q/(/�,-tl.(,V��Iinfri1Phone: 925Veil C Describe the scope of work ' detail: 1 Tear off U Overlay <C**o`sfRof ojeca-S-s,2,510® 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 his 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 resul 'nig • -velop - t righ granted by any issued permit inure to the property owner. vt 5ignature� aSP/ Date -47 '(— v Method of Payment: ❑ Cash ❑ Check ❑ Mastercard ❑ VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 9232005 0 6) v w L ipo 5C.CJ 0. z 0 P4 x cn 0 v z z a fi 0 0