2013, 05-28 Permit App: BLD-2013-0970 RoofPermit Center
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11103 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
4Valle3j's (509)688-0036 FAX: (509)688-0037
www.spokanevallev.orr
Community Development
Reroof Construction
Permit Application
0 Commercial
Residential
SITE ADDRESS: \ a009
ASSESSORS PARCEL NO:
Building -Owner.. -
Name: 0e_
Address. Q Cts�--
State: Zip:
City:
Phone:
Fax:
Contact Person
Name:
Phone:
y' -.J.12 -
Describe the scope of k„ detail:
1
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Contractor:::.:
Narne:
Address:
Morris Clark Siding & Roofing
2728 E. Garland
Spokane, WA 99207
482-2833
City:
State:
Zip:
Phone: y�a7 c7� ? ,�• Fax: c' 4 5j %Q
Exp Date: 1 0•-
Contractor Lic No:
e-20
City Business Lin. No:
00 Tea off Overlay
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Cosi of project: $57700•' c2e22
) Ownership of) this City of Spokane Valley Permit inure to the
The rmitee verifies, acknowledges and agrees by theirer. signature that 1) if this permit is for construction of or on a
dwelling, the dwelling islvvitt be served by potable owner or has pQrmission to represent the property owner in this
property owner. All The construction
signatory isthe property
Spokane Valley
transaction. 4) construction is to be done in full compliance the
ple�� Cpe��e�e��a`Th�SOC,�I� g{�O { orCode.
PReferenced codes are available for review atof the iCity
of of edSp application be
Permit is not a permit or approval for any violation of federal, state or local laws,
approved beforethisapps. 6,. Plans
subsequently app
additional information may be required to be submitted, and subsea,
Ownership of resulting dvelrpment rights granted b an issue pe e to the property owner.
processed.
Signature
Method of Paytnent
Cash
0 Check
Bankcard #: REDACTED
Authorized Signature:
REVISED 8123,2005
Date
[] Mastercard 53 VISA
'mire' REDACTED 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 SOS DAN
G52014-030.
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