2007, 02-23 Permit App: 07000537 ReroofPermit Center
11707 E Sprague Ave, Suite 106
.';WO` Al� (509) Spokane Valley, WA
VQ (509)688-0036 FAX: (509)6&&-0037
Community Development rcrpl..' macallcy erg
Reroof Construction
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PERMITNUMBER:
PERMIT FEE: J
❑ Commercial
Permit Applicationesidential
SITE ADDRESS: IZo "y F . to +'
ASSESSORS PARCEL No.
Building Owner:
Contractor:
Name: %ead�o- L�e.dtG Lo.e1
Name:r,t,4vn
Address: 12oq =. 10+4
Address: 62U ds. Me.do,rl...e
City: S- YM� State jA zip: 1520C
Ciry: S State: Zipimw
Phone: Fax:
Phone Fax:
(Sort 749. 1110 COY) 9v -a- 14w
Contractor Lic NNCRrw4s e Exp Date- o
(70maet Person City Business Lic, No'
Name:
Phone 4S — 7f6o
Describe the scope of work in detail:
Cost of project: $
❑ Tear off Overlay
The permitee verifies, acknowledges and agrees by their signature that. 1) If this permit is for construction of or on a
dwelling, the dwelling istwill 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 develonmeot rights granted by_ary issued permit inure to the property owner.
Signature /���s�� Date -2-1.2',7 f:)
Method of Payment
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
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