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2011, 09-01 Permit App: 11002709 Tear Off, Reroof• Spokane 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 oermitcenter@spokaneva Iley.orq (Staff Use / `7Only) PERMIT NUMBER: l —1 `o? PERMIT FEE: I f �•7 REROOF CONSTRUCTION PERMIT APPLICATION ❑ COMMERCIAL SITE ADDRESS:7f ///Va RES ASSESSORS PARCEL NO.: LEGAL DESCRfIPTION: ENTIAL BUILDING OWNER NAME: C7/ NAME: ADDRESS: CITY: PHONE: FAX: STATE: // ,% CELL: ZIP: CONTACT NAME: PHONE: FAX: CELL: CONTRACTOR NAME: 5ee_ {j (d4 MAILING ADDRESS: CITY: PHONE: �5 " 2 /L417t� FAX: e r v%-: �' �C/� /l0 ll ©b� a76v L ,‘v STATE: L,O CONTRACTOR LICENSE No.: R(5 /?fj.7 ?J74 XPIRES: 7 CELL: -7CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: )ear Off TOTAL COST OF PROJECT: $ 1/ SO 0 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 r resent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Develop code. Referenced co are available for review at the City of Spokane Valley Permit Center. 5) The City of Spokane Valley permit is t a per it or approval or ny violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be regya' ed to bbmitted an/ sub quently approved before this application can be processed. 0 Overlay Updated 1-11-11 Page 1 of 1 http://www.spoka neva I ley.org/filestorage/ 124/938/210/948/1496/Reroof_Permit_1-11-11.doc