2007, 04-18 Permit App 07001322 Re-RoofPermit Center
SpoK.ne
11707 E Sprague Ave, Suite 106
,�.� Valle Spokane Valle -0011 RAA*A 99206
Y (509)688-00 588-0037
Community Development �z,vw.spokaievalley.on_C , U
Reroof Construction- N
Permit Application
SITE ADDRESS / < `� / ),t -c CL r
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Name:
Address: X1,2 o7 ,�-O_
City: a Zip:
1 Phone: /P Fax:
Name:
Phone:
Describe the scope of work in detail:
eq(p e-0 04
Cost of project
❑ Commercial
dential
Lear off ❑ Overlay
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 of resulting development rights granted by any issued permit inure to the property owner.
Signature ���iP`� ,�� �'�-�Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ CashP'—Check ❑ Mastercard
Bankcard #:
Authorized Signature:
REVISED 8/23/2005
Expires:
❑ VISA ❑ Other
VIN#: