2007, 03-15 Permit App: 07000809 Tearoff, Reroof� Permit Center
Spokane 11707 E Sprague Ave, Suite 106
/®ValleSpokane Valley, WA 99206
Y (509)688-0036 FAX:(509)688-0037
Community Development uvww.spokanevallev.ore.com
Reroof Construction
Permit Application
PERNITTNUMBER`:c
KPERMTT FEE:
❑ Commercial
❑ Residential
SITE ADDRESS
//5// Sr,. 1/ �, id 99toy
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
lE ntact Perso
Name:
Phone:
Contractor
Building "owner -s L sf T - _.,_,,,,i
,,iz=
Name: friLsXr
Address: /7,5-"(/ E .S4./ i
City: Sp. U'"' ll�p Zip: 9920 /
Phone: / Fax:
lE ntact Perso
Name:
Phone:
Contractor
: ; - s _ _ —
11 A),....1?
Name: hV$� a . `Tr `,1U r" e_
Address:. 39/0 CA -9, j C O cc-& A,' ti co/
City:Sip r0 Zip: Q%t2y
Phone: 979-6-4',6"C Fax: 7 y7- 3 / 7 /
Lic No: Exp. Date:
City Business Lic No:
Describe the scope of work in detail: I® Tear off
tit.-cr o j4 2cir /cs t P LAD Ps„ -,r`
0 Overlay
Cost of project
sya9. tgit
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 resulting development rightsrantedranted by any issued permit inure to the property owner.
Signature� �G(i��i�' Cl/- /�,e / re / Date 3/ r/7
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