2007, 05-25 Permit App: 07001954 ReroofPermit Center
11703 E Sprague Ave, Suite B-3
pOkaIIe
Spokane Valley, WA 99206
�\Taller (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER: C1 S-47
PERMIT FE
Commercial
FP/Residential
SITE ADDRESS: b Z c" v a I Le j
ASSESSORS PARCEL NO:
Building Owner: l44n k 6,..,7 J J
Name: -�
n . e✓
r1 ack Pe /o S/ra
'C,
Address: 3 16 z E, 'Ja lir t-» v
City: .5 c /�4 State:
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Zip:
Phone: Fax: .5_025,6
Fax:
Contact Person
Name: ':7;„ k gr Le
Phone: 50 q ., .2/ 7- 12. 76,
Describe the scope sope of work in detail: J
6,1)(2 te)- iLe-71 ✓Inp%/ ✓'6'0
Contractor: 0 (ij 62
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
FP/Tear off
Overlay
Cost of project: $ ,� 000
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.
Owners ►• o -s n• dev- •pment rights granted by any issued permit inure to the property owner.
Signatu - i 1 d Date .- 5--6
Method of Payment:
12/Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005