2009, 05-05 Permit App: 09001187 Reroofspoken' e'
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Reroof Construction
Permit Application
-ii87
PERMIT NUMBER:
PERMIT FEE:
/O/ -7S
❑ Commercial
Residential
SITE ADDRESS: / d g o$
ASSESSORS PARCEL NO:
Building Owner:
Contractor:
Name:Name:
/�1 / ii e 1 U '>r p2 In
Name: C'/ak 5-(A fly 4 20 -Ly ,h
Address: ',a?o 3 E /�-L
Address: /r Gct r 10.N a
City: -
e lice i (ex State:StLk 5 Zip:
City: Cpo I
N Q State: (_ ! Zip: c/J70�
I/IK ( 7
Phone:
— Ov 6 0 - Fax:
Phone: r7 ')cps 33 Fax:
( /
Contractor Lic No:oExp Date:
Contact Person
City Business Lic. No:
Car/Name: /� S
r� c vpKt'1't
Phone: .110 ---,..289 3
Describ the scope of work in detail:
je1nou� 0/ 8 Y@oc rnarier,ta
1-106(7
Cost of project: $ a�
Tear off n Overlay
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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 dr
additional information may b - required to be submitted, and subsequently approved before this application can be
processed.
Ownership of resulting,deve - 'ent rights granted by any issued permit inure to the property owner.
Date — S — 0
Signature
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
El Check
❑ Mastercard
Expires:
N.. VISA
VIN#:
Effective October 28, 2007
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P:\Community Development\Building Division\Jodicomm'I\PCF1Reroof Building Permit App.doc