2006, 10-20 Permit App: 06004135 ReroofOct•13, 2006 8:19AM
remut LCDer
apo° kerne 11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development v.ww•spokanevaliey.ora.cnm
..lcVailey
Reroof Construction
Permit Application
No.4613 P. 1/1
❑ Commercial
kResidential
SITE ADDRESS l ZZles AIA jC� Jrsnt_t of �I
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: y k003(--
:Sat
003l .
Name: ytt I ` Sr,J2�
Address ! zzzOJ Ave.
nty: 3{0040.e_kkij)lky W "dip: son I Z
, Phone3O9- 4(`t I / Fax:
Name. &43Qt "
Phone: 5-03'29(1-1141
Describe the scope of work in detail: 74Tear off
re--too-C-4" boaee rmS 3144" le,515 .S7c?e.r
0 Overlay
Cost of project
DISCLAIMER
The permitee verges, 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 develo, ment rights granted by any issued permit inure to the property owner.
Signator a
,, Date I0—I1
Metho • of Payment: - ed permit applications will only be accepted with major. bankcard)
❑ Cash ❑ Check ❑ Mastercard VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8232005
OCT 13 2006 09:57
PAGE.01
V/_t Ai,,,,__
Name: lj cis,-
Address:
J
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
Describe the scope of work in detail: 74Tear off
re--too-C-4" boaee rmS 3144" le,515 .S7c?e.r
0 Overlay
Cost of project
DISCLAIMER
The permitee verges, 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 develo, ment rights granted by any issued permit inure to the property owner.
Signator a
,, Date I0—I1
Metho • of Payment: - ed permit applications will only be accepted with major. bankcard)
❑ Cash ❑ Check ❑ Mastercard VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8232005
OCT 13 2006 09:57
PAGE.01