2010, 10-15 Permit App: 10003390 ReroofPermit Center S6073
St" ®Yana 11703 E Sprague Ave, Suite B-3 3 ,
11[9 Spokane Valley, WA 99206
awasvVa1Yey® (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org 1' '
Community Development
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Reroof Construction
Permit Application
PERMIT NUMBER:
PERMIT FEE:
Commercial
Residential
SITE ADDRESS: 72a3/7 s k (e.l c - r 5 warty L-4 5%tZi,Z
ASSESSORS PARCEL NO:
Building Owner:
Contractor: fc-1 _-
Name:
I1_u.d GI.cvo _k
Name:
Address: 2,220 0 et'vc:40, Roe
Address:
City: S3 -. UAlfeyy State: ca.* Zip: 74,;2_42,
City: State: Zip:
Phone: _'P 7 - P.23 Fax:
Phone: Fax:
Contractor Lic No: Exp Date:
Contact Person
City Business Lic. No:
Name: Pova 6.c
o-aO
Phone: 509' - 3»- 0$o41
Describe the scope of work in detail:
n Tear off Overlay
Cost of project: $ 2062 so
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.
Ownershipting development rights granted by any issued permit inure to the property owner.
Signature
Date 0/45-4J
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8232005