2013, 09-05 Permit App: BLD-2013-1783 Tear Off, ReroofSpokane e��
jValleys
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688-8836- 720 -5;2 yo
Fax: (509) 688-0037
permitcenterCaspokaneva I lev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE: l / ` 1 )
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REROOF CONSTRUCTION PERMIT APPLICATION
Q COMMERCIAL I RESIDENTIAL
SITE ADDRESS:
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME:
N,L) r -t150
ADDRESS:
Nl• ‘-0)-( Bessie Rd
CITY: Spo V.:we- Ycx`key STATE: t„0 iek. ZIP: 99'9-( 2...
PHONE: tLVA \ FAX: h) /A CELL: S� — a 7o . go 1
L
CONTACT NAME: tp eJ p4'son -
PHONE: . So_igle a. 0.).00Je__ FAX: !V /As CELL: N/A
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:.
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Re -root some oCC old down -yo wcc • Pape: c.,nd
sln,ns les replaced
Q Tear Off t1' Overlay
TOTAL COST OF PROJECT: $ I tt 00
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 Taws, codes or ordinances. 6) Plans or additional
Information may be required to be submitted and subsequently approved before this application can be processed.
Signature
Date: 9 - S - j 3
Project
RECEIVED
u
SEP 052013
CSV PE MIT CENTER
RFV r�
Updated 1-11-11 j SUU
http://wwwspokanev611ey.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc
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