2006, 06-07 Permit App: 06002200 Tear Off, Reroof Perntit Center P �� 1�7Avt�ER
Spokane 11707E Sprague Ave,Suite 106
Valley
S okane Valle WA 99206
Valle P y, PERMITFI;'F""' �.�-+ '✓".''
Y (509)688-0036 FAX:(5D9)688-0037
Community Development www
Reroof Construction ❑ Commercial
Permit Application oy Residential
SITE ADDRESS - r OS F� oo 1 /�
ASSESSORS PARCEL NO: USr�l a .1 3S-al- LEGAL DESCRIPTION:) flit la Bktky Did (�1'k-Var&
Buildin owner: = Contractor
Name: /1/4.1 VChQ1IR '{— Mry� LO w1a fL Name: P } l L't5 a_-t .
Address: v '{� Address: 3
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City: Jibs City:Lb-r Ca ` Zip:
Phone: at 44 Fax: Phone: J Fax:
Lic No: Exp.Date:
Cdtl `F.1 Person- ; " = -z City Business Lic No:
Name: MIC CnL LLk—
Phone: d I Q I 1 c(
Describe the scope of work in detail: Tear off ❑ Overlay
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Cost of project Np0000
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
properly 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 --W./ Lf,5,( f Q.-.)Yfllct et Date tf5k1 O,�J
Method of Payment:XI
permit applications will only be accepted with major bankcard)
❑ Cash yI Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8232005