2008, 10-13 Permit App: 08004048 ReroofPermit Center
Spokane 11703 E Sprague Ave, Suite B-3
1�Q` 7 Spokane Valley, WA 99206
VAldeY` pemtitcenternspokanevalley.org
(509)688-0036 FAX: (509)688-0037
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: V(10 6'
PERMIT FEE:
❑ Commercial
Residential
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SITE ADDRESS: (-0 D
ASSESSORS PARCEL NO:
t) -160E
Building Owner:
Contractor:
Name: Inti`UNCk Catus -- -
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Name: C - R Es ski, mosz
Address: 6 /0 s lJ 4>
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Address: // /_ zi Gn�r, ! J_ i/ � n ,�/
City: �fel�fip.�E ��is ySSttate:Ltyg_ e
Phone 0?g9 08i7 Fax: a 7 99
City : �'n_ /� ne V9/ ji f
rt
Sttate:/ )Q Qt 2,
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Phone: c c 41/0 Fax:
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Contractor Lic Ng,,,�wNiv T // ;<Yi-Date: 4449
Contact Person
City Business•Li/ic. No:
(00 2Xi� .,„
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Name: �-p
ice /4/4/0/1/449c,7
Phone: /_ S /37 - c- ,17
Describe the scope of work in detail: Tear off ❑ Overlay
1-E(9 p,c � RES) -1 --Gr Ak)h gelarrr
Cost of project: $ (DO
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
Ownershi, ting develop -nt rig granted by any issued permit inure to the property owner.
Signature ►'' r� �� Date /v -6_0 6)
Method of Payment:
❑ Cash E Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective October 28, 2007
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P:\Community Development\Building Division\Jodi-comm'I\PCI\Reroof Building Permit App.doc