2010, 06-23 Permit App 10001844 Re-RoofPermit Center
Spokane Fes`` 11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
Valley. (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
PERMIT NUMBER:
PERMIT FEE:
Commercial
Residential
SITE ADDRESS: s76'_ ro
ASSESSORS PARCEL NO:
Building Owner:
Name: Lod.eIn n
Address: k.2_ c
g
n
,
Citysr v„tL
State: WA_
Zip:9701 c,
Phone: r q ccw
Fax:
Contact Person
Name:
Phone:
Describe the s_cppe of work in detail:
�Pcr c rerook-.
i
Contractor:
Name: -CMv..r. n _(-
-N Lit
Addresi 6:-
City: ci.t State Zip: 9`j12
Phone:s
Fax: cat) a 1,7
Contract is NoeLsoacout Exp Da e
glio
City Business Lic. No: COOta eqs
Tear off ( I Overlay
Cost of project: $ , Cyry0
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 of Payment:
❑ Cash 1O Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED S/2312005