2008, 07-23 Permit App: 08002846 Tear Off, ReroofPermit Center
��T'�1„�� 11703 E Sprague Ave, Suite B-3
P Vane Spokane Valley, WA 99206
j Vdllev (509)688-0036 FAX: (509)688-0037
J www.spokanevallev.org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: 69--ZcSy-
PERMIT FEE: -'3 7S-
Fl
S
n Commercial
Residential
SITE ADDRESS: /..* 70_5-- `HSN
ASSESSORS PARCEL NO:
Building Owner: _ - _ _'
Contractor: _
Name: .----2,,e-A9/.,/ nnotoiO,/
Name:
Address: / os /71/97/1/Address:
City: /gyp 1/474(e( State: Y /Avg_ Zip: 99q
City: State: Zip:
Phone: Fax:
Phone: Fax:
Contractor Lic No: Exp Date:
Contact Person --- -- -- - -
City Business Lic. No:
Name: (//}moi;
Phone: 1,9-o,3,? /”
Describe the scope of work in detail:
XTear off
Overlay
%t€ OFF %%ice f/N9 c ?I LCL
Cost of project: $
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 rights granted by an iss -d permit inure to the property owner.
Date 7270
Signatu
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
9 Check
❑ Mastercard ❑ VISA
Expires: VIN#:
Effective October 28, 2007
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P\Community Devclopmcnt\Ponos\Budding forms\Reroof Building Permit App.doc