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2006, 04-26 Permit App: 06001564 ReroofSpokane i"alley Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.ora.com Reroof Construction Permit Application P.ERM1TNUMBER: OPERMIT FEE:;: ❑ Commercial 0. Residential SITE ADDRESS 3 i S 5. f1 C b O^ \ ASSESSORS PARCEL NO: LEGAL DESCRIPTION: ft'S.':-F.T 'e iw:T.N� ,'i-'-. `g yt. -Buildm owger ' ; `z ' 4 gi. Name: F rX l OCn ok - \/� Address: £ is' Mem Q,�4/ it3k_M Qi1<.ick_ C ' "" Phone: Fax: flontacts3Pfersonr Name: '%p Phone: 3%©- o947 Describe the scope of work in detail: rpt a t AoI _h✓`;jafi44^tSF'421,y. -_�^iti `±• ✓' �h{.Xyni4".ti4��+_r�x'�`_' Contraetorc= .--,�r-��� _u� -�_ Name: A rf x-DArst& /✓t,✓ ,600%S Address: /ZD y` tie /4/+t2S' ti o/ City: {% a4 ertt/(oke Zip: 2-20/5' Phone: y2.1(- F/0 Fax: Lic No: Exp. Date: City Business Lic No: B"f'ear off 0 Overlay Cost of project ®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 resulfng velopment ri s granted by any issued permit inure to the property owner. Signature Date 2 -VO 6 s 31/ o0 Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check d Mastercard El VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: REVISED 6232005