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2011, 01-03 Permit App: 12000002 Tear Off, Reroof Permit Center polancarr of 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: /Z —U e ZSpokane Valley,WA 99206 _ PERMIT FEE: 7, �Valley� (509)688-0036 FAX:(SQ9)688-0037 / � � �X www.spokanevalley.org Community Development Reroof Construction n Commercial Permit Application Residential SITE ADDRESS: 1 S /) , - ` we'd'doff ASSESSORS PARCEL NO: 11151 117 Z- / 5 Building Owner: Contractor: Name: 6.2 476-3 �77ja L 7 y Name: .2,-.__-03,01,00 '\zr'&t\ Address: /2 2(a w, S+ Address:3W9 _ - iNEt—L 3 s✓Eyl City: ` 5170 vA Lv State: wA Zip:W:20W City: c State: (� Zip:7700 Phone: g35 . c 4 5 Fax: C < Phone: ii53 ql 00 Fax: l� C� J Contractor Lic No: Exp Date: Contact Person City Business Lic.No:pEfe..-t 9 bM4 Rn Name: "(b� 2 i EC, 2 �C., 1 Phone: c{cpa 1 j Ov Desc ' e the scope of work in detail: IN Tear off Overlay ©r I ©oLy .4-yF2 or cone iqfAPLArct ( Cost of project: 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 resume • -lopment rights granted by any issued permit inure to the property owner. Signator _ i - Date //3/// Met •d of Payment: Cash I f Check ❑ Mastercard fl VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 8/23/2005