2014, 04-01 Permit App: BLD-2014-0619 ReroofSCITY�''A„r A �
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Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitrpnter(thspokanevalley orp
(Staff Use Only)
PERMIT NUMBER:
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIALESIDENTIAL
SITE ADDRESS: 3%O oa S. ' $pWe\tS n
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: Th., Kho45
NAME: -lc bsy K y1011 -c
ADDRESS: -lea, Ooh s5‘n
CITY: S peACcIxe Va+\\tv
PHONE: 50 %-3Sfl-Sbz4.
STATE: t _,j\
Fax:
V I�
ZIp: 99 Lo
CELL:
CONTACT NAME: J DI5 K>LO45
PHONE: 5pal -311 -5oZ6 Fax:
CONTRACTOR NAME: ("2, )np/ /? ,/4/
CELL: 5oti-Tact" 6o 7.6
MAILING ADDRESS:
Cm:
STATE:
ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORKIN DETAI`L` AND�INDICATE USE:
-1vis#”\\‘40 of_, st,,,rc+c 03er 'T'r�R. �Cx*,,,,q 5(n�.�Ali.
Tear Off Overlay
TOTAL COST OF PROJECT: $ \ZOO .00
mgr. ATMFR
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.
Signature
Date:
Project # col() t9 -06/7
RECEIVED
MAR 41 2014 3,—
CSV PERMIT CENTER
SUB #
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