2008, 05-08 Permit App: 08001745 Tear Off, ReroofPermit Center
*lanelane 11703 E Sprague Ave, Suite B-3
P 11[Lll Spokane Valley, WA 99206
Valley.
www.spokanevalley.org
(509)688-0036 FAX: (509)688-0037
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: )71.1--
PERMIT FEE: 47;7 75
Commercial
n Residential
SITE ADDRESS: /O a ('IC Qi •s 9-b Gr
ASSESSORS PARCEL NO:
Building Owner: c tic__ . [LG,irp f l
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Name: S f-GVC
Address: /O7 0/ c, fit , Y .7 in
City: 5/4/ acic v (Ctj State: Ct- Zip:TIA0L
Phones 5F 6 3r 0i/ Fax:
Contact Person .'
Name:
Phone:
Descriie seopeccrp in det '1
Contractor:.. [.=', // �
Name: 9 LRL o.�(_� ao �a
Address: /„�1 i> ore &-7 r�
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City: c ri1 ?C- State:
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Phone: O, n 7 . /7 Z Fax: Lich _ �O t ??
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Contracctt),,o rt�
9,Qa iDate:3_ti,aoic
City Business Lic. No:
Tear off
Overlay
Cost of pfoject: $ c -A22
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 oYresLlting develo ent ri hts granted by y issued permit inure to the property owner.
Date s --cr���
Signat
Method of Payment:
Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8232005