2014, 05-05 Permit App: BLD-2014-0951 Tear Off, ReroofSOlane
#Valleyx
Community Developmentilepartment
Permit Center "'
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
Dermitcenter(o�sooka neva Ileo. .or
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
PHONE:
15-0T- WY- 0732z
CONTACT NAME: SCE^
FAX:
CELL: c.,.0 - //71'257L
PHONE:
FAX:
CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF W • RK I DETAIL AND INDICATE USE:
1141 Tear Off
TOTAL COST OF PROJECT: $
thoo
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' not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be r• red to be submitted and subsequently approved before thls application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc
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Je COMMERCIAL
SITE ADDRESS:
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MAY 0 5 2014 (/ /
ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION:
BUILDING OWNER NAME:
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NAME: DeArlgel {///erg- A3
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ADDRESS: 4e(, / 0 / � ((]/L / f'(r �l G'
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CITY: Sg%ie a (7e9
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STATE: a92
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PHONE:
15-0T- WY- 0732z
CONTACT NAME: SCE^
FAX:
CELL: c.,.0 - //71'257L
PHONE:
FAX:
CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF W • RK I DETAIL AND INDICATE USE:
1141 Tear Off
TOTAL COST OF PROJECT: $
thoo
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' not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be r• red to be submitted and subsequently approved before thls application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc