2008, 12-09 Permit App: 08004744 Tear off, Reroof Permit Center
Sokane 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER:
p 1�A.11 Spokane Valley,WA 99206(509)688-0036 FAX: (509)688-0037 PERMIT FEE: /6
�✓ permitcenterAspokanevalley.org
Community Development
Reroof Construction n Commercial
Permit Application Residential
SITE ADDRESS: I-3"" E,i 7 JC)Q F
S puha v1 a Vo141.11_
ASSESSORS PARCEL NO:
Building Owner: G Contractor:
Name: Name:
Pre VI i ei e ASS F'.'-r 50' i'C eS N.J.)I C,i r 1/► Cc) i y v C't1 o VI
Address: Address: s lv cave, `1 loop
City: State: Zip: City:piQ „a pc vl Stater Zip ,S�
Phone: Fax:sm.-659 ,.,c7 N,J j Phone:/5- � 45 j—93 y,3 Fax:
Contractor Lic No: ,, Exp Date:
PA�%c;CC9y7 R ro/i 9/-zo to
Contact Person City Business Lic.No:
Name: 6r ce,L Tim 5 Q vi
Phone: 515 - 3 2 Lj_ 19-56
Describe the scope of work in detail: )C Tear off Overlay
Tav oPF P 00F citcg, egad r.cttc. r, 40piy dD EPO% Rvbly mew br4iic
Q;9Pr�,E Orpv�yt:' dry,&.111 , 4' pk:,rt- rtiviAc c c u+4115
Cost of project: $ i qtj
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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 Date 1 2—cv 9- U 8
Method of Payment:
❑ Cash F Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective October 28,2007
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P:\Community Development\Building Division\Jodi-comm'l\PCF\Reroof Building Permit App.doc