HomeMy WebLinkAbout2009, 10-27 Permit App 09003488 Re-RoofPermit Center
Stne 11703 E Sprague Ave, Suite B-3
P nQll Spokane Valley, WA 99206
.j%1ey (509)688-0036 FAX: (509)688-0037
www.spolcanevalley.org
Community Development
Reroof Construction
Permit Application
9- 3(NY
(l Commercial
Residential
SITE ADDRESS: / 4L / V,4 y(it) 4 (���41/JE �/� LLC— - 9920
ASSESSORS PARCEL NO:
Building Owner:
Name: 7c %frl
.�F / =/ y? / G `>
Address:
City:
State:
Zip:
Phone:
Fax:
Contact Person
Name:
Phone:
Contractor: , /-O ,¢AjC d(?&.r--/it%Cj
Name: L. , DiET�l:
Address: 4 74(-1 /�` i/,ti ,D
City: q , / L f'L 5 State: ►ivfl Zlp: �/ //I.7�o
Phone: /53 _5-5— y 3 Fax:
Contractgr c KoA /SA, 9 43-J. Exp Date: 4 _ /z), Z/ &
City Business Lic. No:
Describe the scope of work in detail: El Tear off Overlay
3,99D .
Cost of project: $
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 dgvelpprpent rights granted by any issued permit inure to the property owner.
Signature
Method ayment:
v42
Date
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED B/23/2005