2013, 02-19 Permit App: BLD-2013-0257 ReroofSpokane
4,015.ValleyY
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@spokanevalley.org
Project # « - \3- e3-7
RECEIVED
(Staff Use Only)
RNIiT" CENTE
PERMIT NUMBER:
PERMIT FEE: "- T
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL
SITE ADDRESS: /7a1
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
RESIDENTIAL
BUILDING OWNER NAME: 16i7 7ct
NAME: kapy
ADDRESS: /74 /1 (/rte
F73 —3.6
CITY:
PHONE:
STATE: (f)c,,
ZIP:
FAX: CELL:
CONTACT
rVNAME: n cwt\ - 4 , ke
PHONE: J t%7' of � FAX: 5-0 5 t of no U CELL: 5-10, a3 C� S3 L c'
CONTRACTOR NAME: TL y} it
MAILING ADDRESS: / 7t0 7/tvea4k3
CITY:
PHONE: J�EXPIR/7�
CONTRACTOR LICENSE No.: TY l L4 L 11 ES:
c -t
STATE: "OK
(2.5y) Litir 00.3 FAX: :7 .
911Y^0l4 CELL:
ZIP: 3, OA
Co 9 `,- X30 ^57th
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETA L AND INDICATE USE:
/aye v ,^6e 4,3
eh�
Tear Off
TOTAL COST OF PROJECT: $ 7 7 1
Overlay
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 . be submi,'s and subsequently approved .efore this application can be processed.
Signature Date: 7;3
Met
E eek- n /isa n MaSter�rd
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Reroof Construction Permit App
10.28.07.doc