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2008, 05-15 Permit App 08001836 ReRoofPermit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 �Valleya (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Community Development Spokane Reroof Construction Permit Application PERMIT NUMBER: ' PERMIT FEE: •7 37A— [7( ommercial Residential SITE ADDRESS: // q'f3 ASSESSORS PARCEL NO: Building Owner: n Name: `LAG ,t�/� AyL _ % ... Address: %747/ Li:. G/G 7 City:79 ` fA 11 State: Zip: fl j 4, Phone: ail v2, Fax: Contact Person Name: 4-/'2 Phone: Describe the scope of work in detail: Contractor: Name: Address: City: State: Zip: Phone: Fax: Contractor Lic No: Exp Date: City Business Lic. No: Q Tear off Li Overlay Cost of project: $ 7 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 re/ Signature �Y Methodr . Pa ment: Cash Bankcard #: Authorized Signature: evelop rights granted by any issued permit inure to the property owner. Date l--G� V P.41eck El Mastercard ❑ VISA Expires: VIN#: Effective October 28, 2007 Page 1 of 1 P:1Conununity Development\Forms\Building forms\Reroof Building Permit App.doc