2006, 05-05 Permit App: 06001720 Tear Off, Reroof ® Permit Center
Spokane 11707 E Sprague Ave, Suite 106ERI
ValleSpokane Valley,WA 99206 ' E " ,00 ' , ,,
Y (509)688-0036 FAX: (509)688-0037 ' ' " ``"
Community Development www.spokanevallev.ora.coin
Reroof Construction ❑ Commercial
Permit Application Residential
SITE ADDRESS 1 9d51 0 e . IL)--f-h. A-0-0-
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Builds `g.owner: , Contractor
Name r\ 3 LU e___ Name: �-�1
`2-.
Address: L LNt t() r' I C7 Address:
`=itY J U Zip: ()3 7 City: Zip:
S'-�(� > ( 00� Phone: Fax:
��° Phone: (�"�
Lic No: Exp.Date:
Co11tatt Persoa ' '�„x
. , r. ?, ,. City Business Lic No:
Name: AlU n
Phone:
Describe the scope of work in detail: >E6ear off 0 Overlay
re,- g00+-
Cost of project s 5. ',on
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 f• any violation of federal, state or local laws, codes or ordinances. 6) Plans or
additional info •1.tion may be req-• to be submitted, and subsequently approved before this application can be
processes.
Owners ip of res in. developm-nt rights grant-• by any issued permit inure to the property wner.
di i
Signatur- i _ 0 ♦� Date
Method of Payment: (Faxed permit applications will only be accepted with ma' r bankcard)
❑ Cash ❑ Check ❑ Mastercard VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/23/2005