2005, 08-14 Permit App: 05003380 Tear Off, Reroof Permit Center
Sfiorkane 11707 E Sprague Ave, Suite 106 •
•
ValleV Spokane Valley,WA 99206 p ' ?
(509)688-0036 FAX:(509)688-0037 x �� nom. :.: ,. �., �.�
Community Development www.spokanevalley.org.com
Reroof Construction S ❑ Commercial
Permit Application f s a 3 y. o305 rResidential
SITE ADDRESS
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building owner Contractor
Name: joName: ).•,.r���-y, ,moi, A '—f Coo,r 7%
Address: Address: 25d/ ,<
City: Zip: City: S�-w•� Zip: mss'1`r' /2
Phone: Fax: Phone: '9,' Y••1‹.,9 Fax:
Lic No:C 'y"..r'Exp.Date:
Contact Person City Business Lic No:
Name: r,3 d c, fir,
Phone: `f 7�9/)Q 7
Describe the scope of work in detail: .ft Tear off 0 Overlay
Cost of project 0
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 i � / Date j/ `f c✓S
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005