2008, 10-06 Permit App: 08003945 Tear Off, Reroof Permit Center
Soe 11703 E Sprague Ave,Suite B-3 PERMIT NUMB : 3`jC/S
pc�rrokane Spokane Valley,WA 99206 PERMIT FEE:
�SVa11er' (509)688-0036 FAX: (509)688-0037 / �
permitcente r(cvspokanevalley.org
Community Development
Reroof Construction n Commercial
Permit Application Residential
SITE ADDRESS: / a 9 0 SAY v /e
ASSESSORS PARCEL NO:
Building Owner: Contractor: la
Name:
Name: 1e yl77 ei " /God cj 'y1
Address: / O 5%-,/ v/ie Address: 15
City: State: >'/ _ Zip: City: ( a g�� State: L/ Zi
Phone: Fax: Phone: / tr 7/ v-73 Fax:
Contractor Lic No:iv Fxpp Date:
..PYlg1eA YYS'.,G,(i) d
Contact Person City Business Lic.No:
Name:
Phone:
D ' e the scope of wo. 'f detail: \ Tear off n Overlay
/ �� �.� i
Cost of project: $ j fd 0.0C
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 res lting development hts granted y any issued permit inure to the property owner.
Signature . / Date
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard A. VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective October 28,2007
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P:\Community Development\Building DivisionVodi-comm'l\PCF\Reroof Building Permit App.doc