2007, 03-21 Permit App: 07000876 Reroof G� Permit Center
Spokane 11707E Sprague Ave, Suite 106 pE „ R ,
.000 Valley (509)688-0036 FAQ (09)6n-0031 E 'IIT e
Community Development \w '.spokanevalley(F .com t k 5.;1 S
MAR 2 1007
Reroof Construction ❑ Commercial
Permit Application ' > `� residential
SITE ADDRESS ID l a y 1 k j
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Bu ding'owner
Name: G1 f I'10 r1'i p
Name: V1f 1G r L' (,�
Address: I 0-7 (-I ✓Z'- Address: '��() I3 / // ) c G
City: ��ti��� b1� Zip: City: fl' (x /' Zip: 90)-! I
Phone:C1 a 4 e(/U[Sl Fax: Phone:1 1-7 0(3D Fax:
Lic No: Exp.Date:
004tact3ersoir 3 V d4 � a � - : City
Business Lic No:
Name:-.J SI/t.AK_
Phone:
Describe the scope of work in detail: ❑ Tear off Overlay
r� 10Ctek S /CSC, I l/a-ties' in)
DIRX` I . sZA/_l s+-( 6A + 5 I c
Cost of project s .50-DD
DISCLAIMER
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 resulti develop ent rights granted by any issued permit inure to the property owner.
...ti-,�� �� _
Date
31-)-1/O7
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
El Cash •' .eck ❑ Mastercard ❑ VISA El Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005