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2009, 09-04 Permit App: 09002848 ReroofSpokane _Va11ey Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Reroof Construction Permit Application SITE ADDRESS: ASSESSORS PARCEL NO: PERMIT NUMBER: Z.7571 PERMIT FEE: Commercial ViZesidential 1 ►d 1(c-Yei%s �2cflci *larr cam{ 106- qQa Building Owner: A C67. Name: eOfC � ,� iJ Name �, No Address: 11,E ` A 4:-/rn Address a �t r. 'Y City: ,, State ml � .�-�[ a 1 ' Zip 2 � � Phone: n� Fax: -6/9- State:l A Contact Person Name: Phone: Contractor:au/yl/ A C67. Name �, No i'Y\ Address a �t r. 'Y 1 City: k £ ,D State:l A 5Y 7 Phone:?- . !a. .— % 3 Fax: ContractortrLic No: Exp Date: City Business Lic. No: Z Describe the scop] e of work in detail: , / , h,, Tear of Overlay .Zior � 1A Ek OT Co'v+^ S%Tir)P'\ Ur% Aooi 6 ;C�Ot�CR 'RG�{'1 ctJ.� gg tc- Ir e+4)I a�.o��,, rr CC+ All 1,1�PsI ��-o�,s cods RS £Xpeg, eC �� The permitee verifies, acknowledges and agrees by their sfnature that: 1) If this permit is forconstruction of or n 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 f. -ny violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be re• uired • be submitted, and subsequently approved before this application can be o of project: $ processed. Ownership of Signature suiting devel ent rig is granted by any issued permit inure to the property owner. Date q1L110� Metho�Payment: i< Cash Bankcard #: Authorized Signature: REVISED 6123/2005 ❑ Check ❑ Mastercard ❑ VISA Expires: VIN#: