2007, 05-07 Permit App: 07001624 Reroof_ Pemtit Center PE[tMIT 3Si71vIDE
Sposkane 11707 E Sprague Ave, Suite 106
Valle Spokane-0036Valley, WA
FA. 99206 PERI dIT FIS: _-`
y (509)688-0036 FAX: (509)668-0037
Community Development ,Vw spokanevallev.ore.com
Reroof Construction 1002 ` 0 ❑ Commercial
Permit Application r Iff/Residential
SITE ADDRESS 100l X E t "14S rn P vly
ASSESSORS PARCEL NO: y 5 9,6ry11II • O(0!53 LEGAL
Contact Ye7sDhl �"., E ;.q;_
Name: /
Phone:
Describe the scope of work in detail:
Address:
Lic No:
24ear off ❑ Overlay
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Cost of project 2SOOr0
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 resulting development rights granted by any issued permit inure to the property owner.
Signature �/{Q
w(L�Gt�t.� Date O
Method of Payment:
(Faxed permit applications will only be accepted with major bankcard)
❑ Cash heck ❑ Mastercard ❑ VISA ❑ Other
Bankcard #:
Authorized Signature:
REVISED WZN2005
Expires: VIN#: