2012, 04-17 Permit App: BLD-2012-0417 Reroof.,I Hilly ..J., 9 I 4A
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REROOF CONSTRUCTION PERMIT APPLICATION
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
nermitcenterCasooka nevallev.orq
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/314- Zo12 0VJ7
(Staff Use Only)
PERMIT NUMBEtR:: W
PERMIT FEE: lc, %,j
E7 COMMERCIAL DigRESIDENTIAL
SITE ADDRESS:
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
I_ .b S.0
L GALESCRIPT ON:
NAME:
Cora ())n r'r-en
J cft,
ADDRESS: :12-).10-k
Crry: SoR(,dF-29
PHONE:
STATE:
FAX:
CELL:
QIP: 9q,211�
CONTACT NAME:
PHONE: . g2_11_ 1 FAX:
CELL:
CONTRACTOR NAME: l l i - lm\ IoS�I
. NAILING ADDRESS: :-,C� X 3 A), rel( ,<' 77 �+ G(/-/�).. F �%.
CITU: J ,Sing -6121+14e � ' FAX: 9 L - //�V 1' / L1_ 1 CELL: TSP:' ( 1��7 it
PHONE: �-(T� h7
CONTRACTOR LICENSE NO.: JT EXPIRES: /1 f J 24 Crry BUSINESS LICENSE NO.:
DES RISE E SCOPE OF WORK N DETAI AND INDIC E USE:
60,2$)L �Y
-dor ` )� A te.' taup).
Tear Off
OTAL COST OF PROJECT: $ qicis
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 submitted and subsequently approved before this application can be processed.
0 overlay
Signature
Credit Card #:
Exp. Date:
Vin #:
Date:
Updated 1-11-11
http://www.spokanevailey.org/ritestorage/124/938/210/948/1496/Reroof Permit 1-11-11.doc
Received Time Apr. 17. 2012 5:16PM No. 7220
Page 1 of 1.