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2010, 10-19 Permit App: 10003433 Tear Off, Reroof Permit Center "� 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: (2-31-7-33 Spokane Spokane Valley,WA 99206 �� PERMIT FEE: do•OValle (509)688-0036 FAX:(509)688-0037 www.spokanevalley.org Community Development Reroof Construction Commercial Permit Application [Residential ITE ADDRESS: 7 3 0 3 ASSESSORS PARCEL NO: v 1 Building Owner: qContraeo . d 0)1/)1////?�/ Name: tn[�A/J/4 /9/9-4-4e', 2 tet/€ g Name Address: .73 D 3 0 3 / Address: City: �7,1v P4-4-7 i // State. ( Zip:-2 City: State: Zip: Phone: g 2,go j.., Fax: Phone: Fax: Contractor Lic No: Exp Date: Contact Person City Business Lic.No: Name: r/3- 1rrZ -- L je_ �2 Phone: CCS V- 7- Describe the scope of work in detail: Tear off Overlay RA- ;& 1'4 2 ©4 a e7s, Cost of project: $ J c ( 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 development rights granted by any issued permit inure to the property owner. Signature L 1. : ). , , Date /O—/9—/D Method of Payment: ❑ Cash ❑ Check ❑ Mastercard Ixr VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 8/23/2005