2009, 04-21 Permit App: 09001020 Tear Off, Reroof n
Permit Center
Sc"T"� 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER:
pokane Spokane Valley,WA 99206 PERMIT FEE:(509)688-0036 FAX:(509)688-0037 �
p ermitcenter@spokanevalley.org
Community Development
Reroof Construction Commercial
Permit Application Z Residential
SITE ADDRESS: IL Si?-� ,•3rd A\i'6 Sep YZ' "J Wk cm 2_610
ASSESSORS PARCEL NO:
Building Owner: at(2.-R Contractor: ,—` �C,eD 5
Name: X10.0 C49-4A-C- Name: V Ca rvio3 �'a l• �1
Address: u gn - 3� rek Address: CI
t) ce 2cf)
City:S v i(y' State: \p� Zip:tiy 240 City: S,e6 K /q.6 State: Zip: 2I7
Phone: 22 U 9 ( Fax: Phone: Fax:
Contractor Lic No: mAR i L--1�y 2DD -e--
! _ /v
Contact Person City Business Lic.No: y
Name: -3--AnitE
Phone: 57)? (4q 1p9 y((
Describe the scope of work in detail: _ Near off Overlay
SHA
Cbril
Cost of project: $ 550 a
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 - •ulting development rights granted by any issued permit inure to the property owner.
Signature t p Date — c2 ( — �(
Method o 'ayment:
X❑ Cash ❑ Check ❑ Mastercard VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective October 28,2007
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P:\Community Development\Building DivisionUodi-comm'l\PCF\Reroof Building Permit App.doc