2010, 05-20 Permit App: 10001451 Tear Off, Reroof1
M1
Sj 6kane` e
cos#valley.
Community Development
/0- /t5I
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.soolcanevalley.org
Reroof Construction
Permit Application
PERMIT NUMBER:
PERMIT FEE:
1 Commercial
Li Residential
SITE ADDRESS: /e.) L. /)7;frdN
ASSESSORS PARCEL NO:
Building Owner:
Contractor:.
Name: 4i /h ;/9-,,- 1 A -A7
Address: /09/0 £ i-27/rs, ,47
City: 5%/,{�N6. acLam(/ State:604. Zip: 97.20%
Phone:Cs O,/) 90�7 _75-74 Fax:
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contact Person _
Name: G(J,,(/i i9 r, le; NGi4'/
Phone: fp, n.S-7 c - 9F9- o€, 9/
Contractor Lic No: Exp Date:
City Business Lic. No:
Dedvibe the scope of work in detail: n Tear off Overlay
ov6 0 ,S'rS�ivrLes r-sJ -c1 Ate. get/
Cost of project: $ ?2R/ 660. oO
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 s -g - -d-b ed permit inure to the property owner.
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
❑ Check
REVISED &232005
Date
❑ Mastercard ❑ VISA
Expires: VIN#: