2008, 11-07 Permit App 08004420 Re-Roof5095338630 p . 1
RECEIVED 11/06/2008 12:26 5096880037 SV PERMIT CENTERFR
> Nov'06 08 01:12a Inland Roofing
RUG 31 2005 10:10 FR
Srnr • Permit Center
` "'•U11707p�E Sprague Ave, Suite 106
^J Jr S09 688V003fiItey,FAX: WA 9920fi(500)688-0037
Community Development ww)
P s 0BoK;Lleva7leY.nrc.mm
Reroof Construction
Permit Application
SITE ADDRESS
`aCp 1 E eg ^t
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
53.59b30 h'. 02702
, Lt`I I j/
7\ j
PERMIT NUMBER
Building owner
Name: ..)
Address: n G) •3 D. Cui.aLts j
City: Gr &nat•t"c$ ii G} Zip: n{qO t!°
Phone: ,(`ct -SD It Fax:
Contact Person
Name:
Phone:
Describe the scope of work in detail:
Ren off- Ntx tS
Cost of project
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) Alt 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 Wiley
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 resultin development rig gr ted by any issued permit inure to the property owner.
Signatur� v .
Date
Method of Payment (Faxed permit applications will only be accepted with major bankcard)
❑ Cash El Check ❑ Mastercard VISA ❑ Other
Bankcard #: Expires: VIN#:
PERMIT FEE: 81.'i 6
❑ Commercial
RI Residential
Contractor
Name: In tzterA g004i q 'S-"opt. j
Address: 55•)3 e !rya--
City: c ,ti Uu.✓a , 1j4 Zip: g9:11.2
Phone: 535 -156,6 Fax: 532-Rb3o
Lic No: j1QLA1k7g,$ OCALIA Exp. Date:
City Business Lic No: U81 taDi Io7G I14
0 Tear off 8 Overlay
Authorized Signature: '
REVISED 3232005
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN 652014.030.
REDACTED
** 'TOTAL PRGE.02 **