2006, 06-29 Permit App: 06002544 ReroofSpokane
10Va11ey
Community Development
Permit Center
11707 E Sprague Ave, Ste
Spokane Valley, WA 9
(509)688-0036 FAX: (5
uw.s okanevallev.or6
°ECS SIE.
p1).:8-0037
JUN 2 9 2
UO��IJ�I
Reroof Construction
Permit Application
SITE ADDRESS ,I1 «/
ID
D
ASSESSORS PARCEL NO: LEGAL D
Name:
ng owne
,P/e4e cCr)
Address: f 7) , 13
City: c// N Zip:
1 Phone..c57) 5 77- :
f
Name:
Phone:
Describe the scope of wor in detail:
RIPTIO>i'
j ❑ Commercial
,L1 Residential
5Tear off 0 Overlay
Cost Qf project
DISCLAIMER
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 resulting developpent rights grated b any issued permit inure to the property owner.
Date
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
II
Cash ❑ Check
Bankcard #:
❑ Mastercard
❑ VISA ❑ Other
Expires: VIN#:
Authorized Signature:
REVISED 8232005
Name: /?4, /�y,k) / t,J 66✓ r
Address: l -
City:'7r'/i'� 1" _ Zip:
Phon/ / 4/77„, Fax:
Lic No: Exp. Date:
City Business Lic No:
5Tear off 0 Overlay
Cost Qf project
DISCLAIMER
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 resulting developpent rights grated b any issued permit inure to the property owner.
Date
Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
II
Cash ❑ Check
Bankcard #:
❑ Mastercard
❑ VISA ❑ Other
Expires: VIN#:
Authorized Signature:
REVISED 8232005