2014, 04-02 Permit App: BLD-2014-0634 Reroofppokane
Valley=
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688 00..,G - 7=t Q —51.2 y(7
Fax: (509) 688-0037
permitcenterPsookanevailey.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
E COMMERCIAL a
SITE ADDRESS: 3 d06 8a-1'
�tESIDENTIAL
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OW-•--- NAME
.SeSC Pel t'oW
NAME:
.5 el' l`C ukCroLc)
ADDRESS:
CITY:
PHONE:
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STATE: lAJ-
FAX: CELL:
ZIP:
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: /� 1 & tc T-�c_ `� 4,'1,1 .�., ( () /i/- c - 7C(5 2r
• MAILING ADDRESS: PC gaV, / '76 y
f " 7?0,2
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CITY:4/21e4CLLk
PHONE:
CONTRACTOR LICENSE No.:
STATE: WC.
FAX:
EXPIRES:
ZIP:,
CELL:
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF
Tear o
RK IN DETAIL AND INDICATE USE:
PPy
ar Off
TAL COST OF PROJECT: $
/66
Overlay
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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 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 subrn(tted and subsequently approved before this application can be processed.
Signature
Date:
RECEIVED
APR 0 2 2014 rk
CSV PERMIT CENTER
Updated 1-11-11 I SUB # 1PagA of 1:,:
http://www.spokanevalley.ora/filestorage/124/938/210/948/1496/Reroof Permit 1-11-1 i ' r'