2009, 10-06 Permit App 09003206 ReroofRECEIVED 10/06/2009 08:56 5096880037 SV PERMIT CENTERFR
Oct 06 09 09:21a Inland Roofing 5095339630 P.1
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r7 '�lKsfjjQ 11707 E Sprague Ave, Suite I06 PERMIT NUivIBER: —��-
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j Spokane Volley, WA 99206 PERMIT FEE: i c•'
"`�1�J (509)688-0036 FAX: (509)688.0037 a7_• _5
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Community Development www ;nevalkv.nre.crom
Reroof Construction
❑ Commercial
Permit Application 9 Residential
SUE ADDRESS _ SIDS E Et.1Q-QL(
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building owner
Name:
I•Sl'1 & i ci {YL VC✓1G
Address:
510 5 L''" Ct,,eUcl
Cl :
u l(i ZIP; aR J12
Phone:
Lily Business Lu No: u131
Contact Person
Namc:
Phone:
Describe the scope of work in detail:
Cost of project
11
Contractor
Name:
Address: 5. - —
Cit : " p :r
Zip: 354 t 0
Phone: 53S fSb/
Fax:
l.ic No: w"*w°`pulikjri
Exp.Dare;
Lily Business Lu No: u131
irOt L' 1 L I ILt
P Tear off ❑ Overlay
7.75
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. q) 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 5 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 d
'— evelopment rights gy any is ed permit inure to the property owner. y
Signature Date
Method of Payment: (Faxed permit applications will only be accepted with majorbankcard)
❑ Cash
Bankcard #:
❑ Check ❑ MastercardVISA Other
al=nnr.TFn REDACTED El
Authorized Signature:
ncViseo arsraoos
L
ocument originally containedtialredit card Information wacted pursuant toRCW19.255010e originaldocumentdestroyed
t to 505 DAN GS2014-030.
** TDTPL PRGE.02 **