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2009, 11-23 Permit App: 09003760 Tear Off, Reroofn DE SSokan Valley. Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www. sp okan eval l ey. org Reroof Construction Permit Application PERMIT NUMBER: ••--(.6,0 PERMIT FEE: 7 -s75- Commercial 7S Commercial XResidential SITE ADDRESS: 10506 E. 11155)D/V ASSESSORS PARCEL NO: Building Owner: - Name: DMA' /nl //3l1 t0�. D)RSTiPC to Address: U AI Address: 1 6 E,7.1 %ss / b A State: City: Sh(92X / !E State:/im c� / Zip: i )06 Phone:5-09 70/ )44/1 I Fax: Exp Date: Contact Person Name: / i 11 h Ec p,/2S l M/E Phone: SO 9 %O( "64/ Contractor: - - Name: {o / n to Address: U AI City: State: Zip: Phone: Fax: Contractor Lic No: Exp Date: City Business Lic. No: Describe the scope of work in detail: i>1 Tear off TEft& OFF / S79£FT 6€7RDor 10!7/t 30 /,€ l9/?fi. Overlay Cost of project: $ f ? U D -- The 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 any issued permit inure to the property owner. Signature p"Ad L -eAJj(� _)� / Date 4134 Method of Payment: n Cash Bankcard #: Authorized Signature: kr heck REVISED 8/23(2005 ❑ Mastercard ❑ VISA Expires: CSV PERMIT CENTER 1 NOV 13 009 Project_� _ 1 Name __________ ISubmittal3f '