2010, 08-23 Permit App: 10002585 Tear Off, ReroofPermit Center
Sfilik �" � 11703 E Sprague Ave, Suite B-3
p AL[LLa Spokane Valley, WA 99206
Vaflley. (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: to_ Z.
PERMIT FEC ,2ct1CCC
Commercial
DIS Residential
SITE ADDRESS: /'(e2- /V LOGct5k
ASSESSORS PARCEL NO:
Building Owner:
Contractor:
Name: lP/ es4 act° Xe Crey eve et
Address: )ta 41. Lc C4C-i
City: 90 _ ✓C�//P�i
Phone: 2 r //6(!
State: tva Zip: cfcY46
Name: 14 r (on5TY`4e.i z L
Address: y/ 3 / C GDvr ree .S�
State: crewn Zip: t 9n 3
City: S
Fax:
Contact Person
Name: -j-tet /{tc 5
Phone: ',3 $ - 7//,?
Phone: has Fax: 539-3e/i,/
Contractor Lic No:T�codi T 9Z'7pp Date: 2 -2,0
City
/z
City Business Lic. No: pd / �f y7 / .2. 7
Describe the scope of work in detail: k Tear off
ter -r Oce 54q k - feS4<ec _ sisk-f(
✓Inti • l.- t -L1 f- 0-j2 htoa
Cost of project: $ 5 0,0
n Overlay
3 oy, toed'.
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 developmentntrights granted by an issued -permit inure to the property owner.
Signature � /«77 Date Er' 23 -/
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8232005
❑ Check
❑ Mastercard [VISA
Expires: VIN#: