2016, 06-05 Permit App: BLD-2014-1302 Tear Off, Reroofa
?OMR Center
Sprague
11703 E SpraAve, Suite B-3
S
Valley
WA
99206
Walley- (5O9)6 -CO36 FAX
(509)
(509)668-0036 FAX (509)686-0037
wwwspokanevallev-ora
Community Development -
Reroof Construction
Permit Application.
Project #
Z
PEW' ill: 2014
CSV OEN'-_Z
C-9 mercial ' '- - - _J
21 Residential
SITE ADDRESS: 11 310E Frea ---er—__
ASSESSORS PARCEL NO:
Building Owner:
Named_IAQtH
Address- t 1 li4l2R ,
City_
Contractor: - - -
Name:
Address:
Monis Cbrk Sldng & Roofing
2722 E Garland
Spokane. WA 99207
492-2833
State:
Zip:
City:
State: Zip:
Phone:
Fax
Phone: -Zi 07Y ?. Fax: 741 -Sot
.Contact Person
Name: tr(
Phone:
Contactor Lic No: ' Exp Date: C._ 1 to
rri ap Iesocp. 1eA
City Business Lic_ No:
De�j be the scope of work in detail: Tear off n Overlay
k eil/101W2 E1/4 W rp-z.F- v3/4Q itirx.e
t r ±w LE' Re -t er eL-civet-zv�.2 . 2a p
Cost of project: $59, b�p�
The permitee verifies, acknowledges and agrees by their signature that 1) If this permit is for construction of or on a
dwelling, the dwelling isfwill be served by potable water_ 2) Ownership of this City of Spokane Wiley 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) Ali construction is to be done in full compliance with the City of Spokane Valley Development Coda
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local taws, codes or ordinances. 6) Plans or
additional information may be required to be submitted, and subsequently approved before this application can be
processed_
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Signature
Method of Payment:
❑ Cash 9 Check
Ban kcard #: -- r REDACTED
U
G
Authorized Signature:
REVISED SQa2005
❑ Mastercard
Date
REDACTED
•rpires- �
RED TED
VIN#:
This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
and the original document destroyed pursuant to 5O5 DAN
G52014-030.
Copy,