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2012, 05-03 Permit Application: BLD-2012-0551 Reroofcz?.Y oe �=- S okane .•••OValley- Community Development Department Permit Center 11703 East Sprague Avenue, Suite B -3 Spokane Valley, WA 99206 Tel: (509) 688 -0036 Fax: (509) 688 -0037 permitcenter©casooka nevalley.orq (Staff Use Only) PERMIT NUMBER: &. ,�- 2Oe2 • a.Sss- PERMIT FEE: .fit /0 t . 7 S REROOF CONSTRUCTION PERMIT APPLICATION COMMERCIAL [( RESIDENTIAL SITE ADDRESS: ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: Q % ric S ?Y1 4O/OV ADDRESS: / c29 iiolows CITY: ke v�11 J7 PHONE: STATE: ZIP: FAX: CELL: CONTACT NAME: PHONE: ^ 361 0 °I CONTRACTOR NAME: FAX: CELL: MAILING ADDRESS: ' (YI G IC CITY: 5G%ci' /6"',•v._ v ` /mil% STATE: • ZIP: -1Gf212 PHONE: oZ I^ p v 9 l FAX: CELL: CONTRACTOR LICENSE No.: U teK Ej(pIRES: CITY BUSINESS LICENSE NO.: Cp 62A2 -qir DESCRIBE THE PE OF WORK IN DETAIL AND INDICA E USE: 70 Tear Off Overlay TOTAL COST OF PROJECT: $ 3, 300 DISCLAIMER The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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). The City of Spokane Valley permit Is not a permi . ..p al for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be re. 'red to be ubmitte. n ubsequently approved before this application can be processed. Signature 1r\ Date: Updated 1 -11 -11 Page 1 of 1 http:// www. spokanevalley. org/ filestorage /124/938/210/948/1496/Reroof Permit_1- 11- 11.doc