2013, 08-26 Permit App: BLD-2013-1703 Tear Off, ReroofSpokane
Valley
ri COPY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 6-3
Spokane Valley, WA 99206
Tel: (509) 688-0036 :
Fax: (509) 688-0037
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2O 13 -1-161
(Staff Use Only)
PERMIT NUMBE
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APRLI,CATLION
COMMERCIAL
SITE ADDRESS: 5. asOq gooactis km 20.1
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: kb L 6 1013
RESIDENTIAL RECEIVED
BUILDING OWNER NAME:
NAME: ytl�v 1 \ v v�V t✓t�,,.x� {, �j 'a
ADDRESS: B. R'Cscx&''cS1 `z k .
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FrICNE:
STATE: W
SUB#LI Fes. +,
Zoco
ZIP:
FAX:
CELL:
CONTACT NAME:
CONTRACTOR NAME:.$4)f jk2 yip_ ,^,r-dit I r L-
MAILING ADDRESS: �\ 2)0 e- �,,1U\N� pct
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CITY: ^ L\C(...mt J `tS(TATE:) /WA %�Qt
PHONE: — n] �i V --?1:572 FAX: C'�./�1Z�`.I'�—nC t 0
CONTRACTOR _ICENSE No.:40ur+ec�� Q.a EXPIRES: q2.015 --CITY BUSINESS LICENSE NO.: (,..WL)31
:DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
CELL:
ZIP: 111,62—
CELL:
126Z
CELL:
Tear Off I I
TOTAL COST OF PROJECT: $ Li (t—t,S1•.00
C Overlay
DISCLAIMER
.e-e.aeS >ritaS, ac<rowle0SeS and agrees by their signature that:1) if Ibis permit is for cOnStruCt'On o- or. a C'nell ng, :re
2) Ownersn p or Iris City o' Spokane Valley permit .nure to :he property O'n rte'. 31 Tne slgrat:r} s cle
r :r -is pert:. ss sn to represent tune property owrer.n tnls transaction. 4) All (onstrL Coon l5 to be Cone lr fir:! romp.ler:E. A e -
:a�e• Ce.e.:pr'ent Code. Reierenced Codes are available fa: review at the City of Spo<ane Vai.ey Pe-m�c Center is ^. _
_ _ -tut, i errn.t it floc a permit or approval for any violation of feeera', state or Loom laws, codes a' orelnaaces 6) PIer; i. 3::
- -, - ..'_, Le rep -rep :0 be sub'ttltted and 5. bseq-ently approved before this apot.tation can De pre:Esse°
Signature
Date:
IdetncC cf payment: C Cash �hec.< E MastercardEar csro • REDACTED
DACTED ) 5 =xP, _ REDACTE4tn
A.:Firenze:1 Signature
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10.29.0:
0669-/ bL (609)
This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
and the original document destroyed pursuant to SOS DAN
GS2014-030.
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