2009, 08-18 Permit App: 09002571 Reroof -
• Community Development Department
Permit Center (Staff Use Only)
c'S�"' 11703 East Sprague Avenue, Suite B-3
kane Spokane Valley, WA 99206PERMIT NUMBER' 9.- vi��/
valley), Tel: (509) 688 0036 a�� -7�^
Fax: (509) 688-0037
permitcenter@spo4000
kanevalley.orq _ _
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL IN RESIDENTIAL
....___),SITE ADDRESS: 3 C/5-5 k;cI o, aod� SPCA a,-,e (/L.74),r J��c7 O 6,
ASSESSORS PARCEL NO.:❑❑❑❑❑ LEGAL DESCRIPTION:❑t-1❑❑L
BUILDING OWNER NAME:
NAME:KIRK APPLEBY
ADDRESS:3515 S. RIDGEVIEW
CITY:SPOKANE VALLEY STATE:WA. ZIp:99206
PHONE:869 6131 FAx:❑❑❑❑L CELL:❑❑❑❑F
CONTACT NAME:❑f Hi ❑
PHONE:I II [Mr] FAX:❑LLLL CELL:[ []f_I-i❑
CONTRACTOR NAME:COVINGTON CONSTRUCTION
MAILING ADDRESS:14415 SPRAGUE
CITY:SPOKANE VALLEY STATE:WA. ZIP:99206
PHONE:954 5554 FAx:I 1114,H1 CELL:I [ 11 11
CONTRACTOR LICENSE NO.:COVINCR944CH EXPIRES:[ 11111111 CITY BUSINESS LICENSE NO.:t. I I I.
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
LI ❑I HI
f l 'LLH
0 Tear Off ❑ Overlay
TOTAL COST OF PROJECT: $12500
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The 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.
ignature
;,- ------ --=---------- Date.❑[',❑❑❑
Method of payment: Cash__ --------Ertheck ❑ Visa ❑ Mastercard
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Bankcard #:I II ;I H IL EXP:❑L'f ['l I VIN#:❑❑L I L
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
C:\Documents and Settings\James Stopar\My Documents\Reroof Construction Permit App.l.doc