2013, 05-01 Permit App: BLD-2013-0781 ReroofMay 01 13 12:15p
Alpine Construction
SiStikane
4Valey
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206 - r n p 1
(509)688-0036 FAX: (509)688-003
'r er
tnsmt:anevalley orx
Reroof Construction
Permit Application
SITE ADDRESS: I t i S F L SRA
ASSESSORS PARCEL NO:
509-448-5504
p.2
El Commercial
[Residential
Describe the scope of work in detail:
Tear off ❑ Overlay
Lew S, e P P
o!+ -Ty o ca o(r r eau L.
Cost of project: $ o
The rmitee verifies, acknowledges and agrees by their
s permit is for construction of or on a
dwelli l signature If
g, the dwelling is/wit! be served by potable water. 2)Ownership of thisC yr of Spokane Valley Permit inure to he
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 available for approval forsew at any violation f fedehe City of ral, state or locae Valley lt laws? codes or ordinanceser. 5) This City of . 6)a Mans or
Permitdis not ar permit or app
additional information may be required to be submitted, and subsequently approved before this application can be
suitingOwnership of r development rig granted by any issued permit inure to the property owner.
processed.
Signature
Method of Payment:
❑ Cash
Bankcartl #:- REDACTED
Authorized Signature: /
0 Check
D Mastercard
Expires
-
Date
s-�l) 3
El VISA
thEDACTED VIN#- ^ REDACTED
Effective October
Page 1 of
P:\Community Deveiopmarffioilding Division\iodic
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.