2006, 11-14 Permit App: 06004515 Tear Off, Reroof •
•
Sri Permit Center
6kane 11707E Sprague Ave, Suite 106
Valley Spokane Valley,WA 992061 � Ec "'
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevalley.org;.corn
Reroof Construction ❑ Commercial
Permit ApplicationResidential
SITE ADDRESS ( 3 OO ) 004 3 I s'f
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Bu din -owner `Contracator _.. 1 .
Name: ,_ ity ` st Name: jeC.tiat E-AA_
Address: /30da cf. 1300 C1 Address: 16 fU /tichi,edd
City: C F //(-44A° VaXy Zip: 5,7e7W,6 City: ..cle -v2 /c .y Zip: P9,) /f 6
Phone: Fax: Phone: 579-R4.7-0-W.-Fax: n/ /^�,�,
Lic No: 1. �� / Exp.Date: 7/-<7/ Oect
111 (((
vntat„ eirsd/ ;.,: z �� . City Business Lic No:
Name: J, '` t .K �,-a-e-
Phone: g6 3 _
Describe the scope of work in detail: XTear off 0 Overlay
14-46
Cost of project $ 5-0 42'
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 o --. ns .rn'•- os r r. s granted by any issued permit inure to the property owner.
Signature
i�-�--- Date /(/l17/:76
M Tiod of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/232005