2013, 08-21 Permit App: BLD-2013-1659 ReroofSpokane
Valley
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 @sookanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE: Q 1 %
"-7 5
REROOF CONSTRUCTION PERMIT APPLICATION
C]' COMMERCIAL
SITE ADDRES •
ASSESSOR PARCEL NO.:
BUI ' ING OWNER NAME:
NA E:
ADD E
CITY:
PHONE:
31-7
RESIDENTIAL
LEGAL DESCRIPTION:
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STATE: (
CONTACT NAME: 41
FAX:
c ILL t 1-1-60
CELL:
ZIP: 7 6 3 7
PHONE: 5(2 9 ci 6L( /( i 6 FAX: 51. 1
CONTRACTOR NAME:
CELL: (S << /6 [6
MAILING ADDRESS:
CITY:
PHONE: (�
1 i
(}c„. J1-c- y
f S3a o
CONTRACTOR LICENSE No.:
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STATE: u, 4- ZIP:.
FAX: _f ( _SA y 6 CELL:
EXPIRES: CITY BUSINESS LICENSE NO.:
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DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off
OTAL COST OF PROJECT: $ / 7 S 00
Overlay
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 tra action. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes re avails a for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a perms or approval for y violat of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be su mitted and sub quently roved before this application can be processed.
Signature
s
Date: < a
Project #.
7_0j3— NO
RECE VED
AUG 2 1 2013
CSV PC. ?:`' '" CENTER
Updated 1 -11 -11 f thigeifOf 1
http: / /www.spoka neva lley.org /filestorage/ 124/ 938 / 210/ 948 / 1496 /Reroof._.2ermit`1- 11- 11.doc