2007, 03-27 Permit App: 07000961 ReroofSpokane
esorsovalley
Community Development
Perrmt Center
11707 E Sprague JA-ve,\Suite 106
Spokane Valley, v',D996 FE
(509)688-0036 FAX:'(509)688-0037
a ww.spokanevallev nr .corn.
mAR
Reroof Construction
Permit Application
72007
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12:TERMI .NUMBER
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)rPERMIT-T•F,F
❑ Commercial
❑ Residential
SITE ADDRESS U 3 Z
ASSESSORS PARCEL NO:
(1 7)./u.
LEGAL DESCRIPTION:
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Sl
`Builrtin �'avcner'�"; : ": ��x.=�«�.�
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ate' -
Meli
Name: 0 - k W1- i
_ .ili 8321 C.
Address:
City: j...1-.. <.:
. Z_I2-..
Phon: 50 9I a- 2 L
Phone:
Phone q `L Z -
Describe the scope of work in detail:
0 Tear off IZ 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 o esulting develop ' t rights ranted by any issued permit inure to the property owner.
Signature it/Yr
Method o
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
Date'
P. yment: (Faxed permit applications will only be accepted with major bankcard)
❑ Check
❑ Mastercard
❑ VISA ❑ Other
Expires: VIN#:
Contractor .:s
r= u T
Name: 0 - k W1- i
Address:
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
0 Tear off IZ 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 o esulting develop ' t rights ranted by any issued permit inure to the property owner.
Signature it/Yr
Method o
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
Date'
P. yment: (Faxed permit applications will only be accepted with major bankcard)
❑ Check
❑ Mastercard
❑ VISA ❑ Other
Expires: VIN#: