2010, 11-03 Permit App: 10003664 Tear Off Roofing RECEIVED 11/03/2010 10:25 5096880037 SV PERMIT CENTERFR
Nov 03 10 11 : 03a Inland Roofing 5095339630 P. 1
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Q 11707E Sprague Ave,Suite 106 hI ,7 PERMIT NUMBER:
pni, Spokane Valley,WA 99206 PERMIT PEE(S ,
(509)688-0036 FAX:(509)688-0037
Community Development www.ipuicsnevallev.nrq.com
Reroof Construction ❑ Commercial
Permit Application $ Residential
SITE ADDRESS 1 t. L t q%'
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building owner Contractor
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Name: Rork L t1i Name: Inkt.;yet RJ7t7 M .( j.ne.
Address: 11 Std V rias A-ri" Address; 55.5s N. c 'CfC_r}tc4� i Z
City: J icii.AL_ lruLt.* Zip: ` 11 City:�ri'`LZ 1kt(Ec, Zip: e.1
Phone: 53.E-•Y Fax: Phone: 53-c--i 5 V- Fax: s. 3-' (-30
Lic No:110i ?Ct4LL A Exp.Date:
Contact Person City Business Lic No: Ll,:t 1071, 11'4
Name:
Phone:
Describe the scope of work in detail: lig.Tear off 0 Overlay
Cost of project s 3 34s•w
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 properly 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,stale 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 resulUn, development rigr - y issued permit inure to the property owner.
Signature F Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check El Mastercard ❑ VISA ❑ Other
•
Bankcard#: Expire§:--, VIN#:
Authorized Signature: '✓•. (�
REVISED ae:nD05 -.
TDTAL PRGE.92 **