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2005, 10-28 Permit App: 05004081 ReroofSpakane �� Valley Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org.Corn Reroof Construction Permit Application PET NI1ER { PERMIT EFF: - _ka w ❑ Commercial Residential 7 SITE ADDRESS ` k (p E . ASSESSORS PARCEL NO: LEGAL DESCRIPTION: Building owner Name: ON 1 L Address: It. 1 1 L, C v LU t1 Zip: a City: �j r o (Lc Phone: Fax: on ac erson Name: Phone: Describe the scope of work in detail: �— Contractor Name: f j -)-o Om 6 t6 /.�,./ c '^`..) Address: / Zc9 N flemc Fey -.-c 1 City: L , 4 c Zip: y 5vi Phone: 12 - Fax: Lic No: Exp. Date: City Business Lic No: 0 Tear off /Overlay v ,s'_.. -s Cost of project $ 1100 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 of resulting development rights ted by any issued permit inure to the property owner. Signature `��► `' �� Date [C7/2x-/U5' Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash Bankcard #: Authorized Signature: REVISED 8/23/2005 El Check [Mastercard ❑ VISA ❑ Other Expires: VIN#: