2011, 09-14 Permit App: 11002855 Re-Roof1�
Valley..
community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tef: (509) 688-0036
Fax: (509) 688-0037
permitcenter(aspokanevailev org
(Staff Use Only)
PERMIT NUMBER: _Z �Jp
5_6_
PERMIT FEE' 3 7 7- f_
REROOF CONSTRUCTION PERMIT APPLICATION
Ej COMMERCIAL aRESIDENTIAL
SITE ADDRESS:/ J O ?
ASSESSORS PARCEL NO.: �S1g�3 �Z g L GAL�DESCRIp N'
BUILDING OWNER NAME:
NAME:
ADDRESS'
PHONE:
CONTACT NAME:
PHONE. . .C_�
CONTRACTOR NAME: '-11
MAILING ADDRESS:
CITY:
91-1—
CONTRACTOR LICENSE: NO.:`
STATE:
ZIP:
CELL:
CELL:
ZIP:`
CELL.
=�----
CITY BUSINESS LICENSE NO..-
BE
O.:
BE T" E" KSCOPE
1�( RK IN DETAIL AND INDICATE USE,-
Tear
SE:
Tear Off
❑ Overlay .
TOTAL COST OF PROJECT: $
0.9019'
7
DISCLAIMER
The ermittedrve�lPlest,���Po��edges agd�q�eg,��itr�i������f� 6a� ,
P""'i)�f if?!S '&t�'tG 16�e" NfQR�rtjl`�44A 3 j fl�'si'�natory'fi'e" property
owner or has permission to represent the property owner in this transaction. 4) All -construction Is to be done in full compllanCc with the Gty of
Spokane Valley Development code. Referenced codes are available for! review at the City or 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 to be submitted and subsequently approvedbefore this application can be processed.
Signature
I
Credit Card #:
Exp. Date:
Vin #:
Date:
Updated 1-11-11 i
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/RerooF Permit 1-i1-11.doc Page 1 of 1
Received Time Sep. 14. 2011 11:44AM No.4451