2006, 10-27 Permit App: 06004317 ReroofSpokane
4.00. Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. spokanevall ev. or�.co m
Reroof Construction
Permit Application
ERMI FE
❑ Commercial
Residential
SITE ADDRESS 3 01 - 30c(
ASSESSORS PARCEL NO:
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LEGAL DESCRIPTION:
Btt
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Name: j_Q,[W-c9L SOe✓icXfrs
Address: 301 4 369 _ N e v C I el
City: .) p a \J 4tel Zip:
I Phone: - Q (1 G Fax:
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Name: En; L M' -
Phone: - 569
Describe the scope of work in detail:
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Name: %eh and CislA 5)
Address: Q -t 6 N 5u. A J4 � t Dr
City: S?o .O"-( Volt e1 Zip: qS21(,
Phone: (8q1 -1(14( Fax:
Lic No: ieleR 1V_CIQ2)....1 Exp. Date: 5) Z .g
City Business Lic No:
0 Tear off
Overlay
Cost of project
l5co 344)6—
DISCLAIMER
04)6—
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 re' g d velop e t rights granted by any issued permit inure to the property owner.
,
/ 1)
Method of Payment: (Faxed mit applications will only be accepted with major bankcard)
Signature
Date /6 ' 71- 26G
❑ Cash X Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/2312005