2009, 11-16 Permit App: 09003692 Tear Off, Reroof .'' . Permit Center
S ,._ (..0c-17
°®► 11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:okane
Va11eY (509)688-0036 FAX: (509)688-0037 PERMIT FEE: //S
www.spokanevalley.org
Community Development
Reroof Construction (l Commercial
Permit Application Residential
(1 401-1
SITE ADDRESS: -----�-- (_ J(�.��'� 'c.(C�1
ASSESSORS PARCEL NO:
Building Owner Contractor
( �7I.� Name:
Name: c�v(L � � �s�i.u��o,� L
Address: (LI01
Address: Z FW �Z2
Zi City: State: Zip:
City: S � State: �✓/4 p' �9 20,c, 5 ����.� (,�� `l ZOL
Phone: ax Phone: Fax:
cO 7 2 S'" (4- 2_
Contractors,ic No: --Exp Date:
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Contact Person City Business Lic.No:
1 &O2 1S-ci SSv
Name: 15� ,� 1T C., A1_;
Phone: co -- `7 -7477
Describe the scope of work in detail: n rear off i Overlay I / I
ic.�� CYO t j� gra VC/JC( c,-u� r e�% c-1-0 �2.���( �l.c(,ha)A-)
Cost of project: $ �csz7
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 s - s ' = development ri hts granted by any issued permit inure to the property ner.
Signature /.
Date j ç2i
eo
41p
Method of Payment:
❑ Cash Ei Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005