2010, 09-14 Permit App: 10002897 Tear Off, Reroof ,'A Permit Center
SpUkane 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: 2`fT7
Spokane Valley,WA 99206
PERMIT FEE c�-1-�
Valley. (509)688-0036 FAX:(509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction Commercial
Permit Application ✓Residential
SITE ADDRESS: i 4..t of t( E. (i+1,_ sr,4,_.-„_v r Le c\-- c(4 37
ASSESSORS PARCEL NO:
Building Owner: Contractor: O1/4_,..--- (--s-c^
Name: (,V n WO
( F Name:
Address: (y6t( ( t'` ( ( t-{,, Address:
City:c ,__Vo_d_t_ State:GJA_ Zipy9c8 7 City: State: Zip:
Phone: Fax: Phone: Fax:
Contractor Lic No: Exp Date:
Contact Person City Business Lie.No:
Name: nctUIS c(,t,-
Phone: (irch Cr cl l— is':5Yf
Describe the scope of work in detail: Tear off Overlay
&r- -o&4 (ct.r✓Q 420 t,.VV ecf✓' ( r *c(c4,1 t--v-e_.( -
Cost of project: $ aCer) —66,
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.
Signatur Date - / /.--/C)
Method of Payment:
❑ Cash ❑ Check n Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005
13-782 500 SHEETS,FILLER 5 SQUARE
42.381 50 SHEETS EYE-EASE.5 SQUARE
National"Brand q2.89 700 SHEETS EVE-382 100 SI-IEE FSEEns s so aRE
Re
42.392 100 RECYCLED ElHITE 5 SQUARE •
42-399 200 RECYCLED WHITE 5 SQUARE
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