2011, 09-13 Permit App 11002878 Re-Roof09/13/11 10:32PH HP LASERJET FAX $09-747-6687
SOn, Permit Center
he 11707 E Sprague Ave, Suite 106
Vallelle Spokane Valley, WA 99206
VQl l y (509)6$8-0036 PAX: (509)688-0037
Community Development �' eookanevallev.nr¢.cntL
Reroof Construction
Permit A>pnlication
SITE ADDRESS
ASSESSORS PARCEL R
LEGAL DESCRIPTION:
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Name:
Phone: ` 4� l j '� -z ,f ...
Describe the scope of work in detail:
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❑ Commercial
❑ Residential
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Name: 6 ''/ c,....,...'.:•
Address:
City: c r- >k'c! .... Zip--
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Lrc1�1o: Exp. Date:
Ci Business Lic No:
;,�,..Fear off ❑ Overlay
Cost of project $
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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�' -- —
,,,--' Date
Method 9rga-yment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check Mastercard
Bankcard #:
Authorized Signature:
REVISED KnOO5
Received Time Sep.13. 2011 7:26AM No.4422
Expires:
❑ VISA ❑ Other
VIN#: