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2012, 10-02 Permit App: BLD-2012-1718 ReroofSpoLam e� FValleyx Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenter@spoka neva Iley.orq (Staff Use Only) PERMIT NUMBER:I✓ lC( ^/� Z - ) 7 i 6 PERMIT FEE: ( 57,x REROOF CONSTRUCTION PERMIT APPLICATION El COMMERCIAL Q RESIDENTIAL reetErarS i SN 8cky ke , v,qc+ v e s, lA%c�, 2 ? t) / G ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: NBOTILDING r ADDRESS:. Cm: PHONE:'� th GONTACTJNAME lips E: .c c 3 - T2,6 ��/-rCj�g) t / FAX: CELL: CONTRACTOR NAME: 671.774e/7Teti STATE: roc_ AX: CELL: ZIP: MAILING ADDRESS: CITY: STATE: ZIP:. PHONE: FAX: CELL: CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBETHE COPE wisn D2. aQ Co (Lai Tear Off ti LrFWORKIN\DDETA'- ANDINDI •TE _fE• t r OTALf{COSTto MY) E CALLS:AV, 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. orignat e, 42;r274,(7 dleswk Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc