2010, 02-23 Permit App: 10000494 Tear Off, ReroofPermit Center
Spokane 11703 E Sprague Ave, Suite B-3
Wane Spokane Valley, WA .0•0Valley. (509)688-0036 FAX: (509)688-0037
www.spolcanevallev.org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: /0 oy 9j 4/
PERMIT FEE: /0/• '73
❑ Commercial
Residential
SITE ADDRESS:
ASSESSORS PARCEL NO:
Building Owner: -_- _ - :'i�51 :
Contractor:
Name: CD U(. I') J�1 C S /v/
Win/CS
Name: �% m P-
Address:
Address: /c....-,--,
3 a� r, r'Ig ra P L 1.
7.3
City:
Rhte L/ `,4cy l t2t1t � G 2 /
City: State: Zip:
Phone: Fax:
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Phone: �_� e, l q Fax:
Contractor Lic No: Exp Date:
Contact Person ..
City Business Lic. No:
Name:
Phone:
Describe the scope of work in detail:
—efrile Orr 14 -AS d'PE_,oi pn a
XTear off
ienntri
n Overlay
Cost of project: $ 350a
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 suiting development rights granted by any issued permit inure to the property owner.
P'�
Signature c V4d cif, 2 Date Z— t3
Method Payment:
❑ Cash IK Check ❑ Mastercard ❑ VISA
Bankcard #: j� Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005