2007, 07-13 Permit Reroof 07002701 Reroofrn �r Permit Center
Spokane 11707 E Sprague Ave, Suite 106
ValleSpokane Valley,99206
Y (509)688-0036 FAX:
(509): (509)688-0037
Community Development vww.spokanevalley.ore.com
Reroof Construction
P>iRMTT3�RiMBER �:
PERMIT FEE ,
❑ Commercial
Permit Application fO Residential
SITE ADDRESS lZ(ooy to '�.Qsr>j?k
ASSESSORS PARCEL NO:
Address:
Fax:
Contact Person
Name: o n
Phone:
LEGAL DESCRIPTION:
99UG -J9,;o
Contractor
Check
Name: t^
�r rS lruCie Co ,
Address: �9i7 f
Tiwnc4
City: ,,�,�
zip: 9 9aoer
Phone: V&C- V IVI
Fax: NG8 SZ�S/
Lic No:C4P5TC(Ie4SS Exp. Date:
City Business Lic No:
VIN#:
Describe the scope of work in detail: Tear off ❑ Overlay
W %n J 4-a f oof l-a.mo ue- amt, lr. uerS �o d� r; , a ✓c -roa F
Cost of project spp 0,
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 resultin elop t rights granted by any issued permit inure to the property owner.
Signature -7-1-3-07
Date
Method of Payment: ( axed permit applications will only be accepted with major bankcard)
❑ Cash
Check
❑
Mastercard
❑
VISA
❑ Other
Bankcard #:
Expires:
VIN#:
Authorized Signature:
REVISED 9232005