2010, 09-09 Permit App: 10002811 Reroof Permit Center r C) -
of , _ PERMIT NUMBER:
S�Okane
11703 E Sprague Ave, Suite B-3
11[iii Spokane Valley,WA 99206
4o00 PERMIT FEE:Valley6 (509)688-0036 FAX: (509)688-0037 I �
www.spokanevalley.org
Community Development
Reroof Construction Commercial
Permit Application IV Residential
SITE ADDRESS: ` J/2 r 49/I- t
ASSESSORS PARCEL NO:
Building Owner: Contractor: Avseixerc
Name: Name:
/73 / 97-e-4?
Address: 5.3/2 g z Address: /a 4 97ii6
City:����n�11.4/7,✓, ,State:Gt/� Zip: Cityd` StatemJ Zip:,1,91a/
Phone: / Fax: Phone:c;//../p Z/ Fax: a�g s—� /
Contractor<Liic�I�rU Exp Date: ,'4�/
/ bbrhel Z/1''� /,
Contact/./Ar-,,s-
PJJ��erson AA City Business Lic.No:
Name: (iL4/`f G��(/o
Phone: 0//7-/g2a
Describe the scope of work in detail: ar off Overlay
Cost of project: $ St'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 b- required to be submitted, and subsequently approved before this application can be
processed.
Ownership of g ►- -lopment rights granted by any issued permit inure to the property owner.
Signatur. / Date 9—
Method
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005