2008, 10-01 Permit App: 08003894 ReroofSioliane
Walleye
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcemer@ spokanevalley.org
Reroof Construction
Permit Application
SITE ADDRESS: iL5 0 Z /
ASSESSORS PARCEL NO:
-5%9PERMIT NUMBER O
PERMIT FEE: 1
) 2q
n Commercial
Residential
Building Owner:
%{
Name:. jf-f -- e. l �� M(c4e cl/i Ke_
Address: OZ--SOZ r.
City:5a)1(.44._(A((e y State: /,)61 Zip:
eC,K
Phone: V Fax:
Contact Person //
Name: --7704 bb 1h4 a,-,
Phone: 2($— 61 Z9
Describe the scope of work in detail:
Teel'
Cost of project:
Contractor:
Name: / gCo- ,0
Address: /6zg 64,34c9%
City: So,/at, State: ("diS
Zip: / 9ed y
Phone( 0 _ J(z 47 Fax:
Contractor Lic No �ft tf✓ ► t4g4g�?! Date:
City Business Lic. No:
Overlay
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 result' • - - opment rights granted by any issued permit inure to the property owner.
Date 476 Z e5
Signatu
Met ayment:
❑ Cash
Bankcard #:
Authorized Signature:
❑ Check
❑ Mastercard ❑ VISA
Expires: VIN#:
Effective October 28, 2007
Page 1 of 1
P:\Community Development\Building Division\Jodi-comm'1\PCF\Reroof Building Permit App.doc