2014, 12-09 Permit App: BLD-2014-2924 ReroofSj�k
.MiHey
Community Deveioprroont Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spoka nevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
ID COMMERCIAL 0 RESIDENTIAL
Project ==
SITE ADDRESS: 7a i id . Ner4
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
RECEIVED
/4/
BUILDING OWNER NAME:
NAME:
ADDRESS: •? 2. i N 1 i— � A:)
11H U9 2014
Civ HE:R1,MIT CENTER
CITY: )6 v11ki�i 3S STATE: �J SU
REV.
PHONE: FAX: CELL:
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: DG
MAILING ADDRESS:
g cAc,erc\ 02.,‘& `CU. -
CITY: ei Lam. r STATE: W i
PHONE: 7O 6 C - FAX: CELL:
CONTRACTOR LICENSE No.: ,JCD CotA A EXPIRES: ,'2• ICS
ZIP: qC1O1Ci
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
'Tear Off
TOTAL COST OF PROJECT: $
❑ Overlay
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) If thls 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 sum Itted-and-subsequently approved before this application can be processed.
Signature
Date: (2 -
Updated
2 -
Updated 1-11-11 Page 1 of 1
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