2014, 04-10 Permit App: BLD-2014-0815 Tear Off, ReroofSpokane
#Valleys
Community Development Department
Permit Center
11703 East Spra"yue Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-8936— 720 -512V0
Fax: (509) 688-0037
permitcenter(alsookaneva Ilev.oro
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
Ei COMMERCIAL IV J Q RESIDENTIAL �yl�
SITE ADDRESS: di Q rV . f aGM St 9 9 4 tr I Project # D
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION; (i t V t I V b U
BUILDING OWNER NAME: Aioat 0eel/0od
NAME:
ADDRESS:
t inn' • n ans.
CSv rtHMIT CENTER
CITY:
STATE:
SUB # REV. #
PHONE:
FAX: CELL:
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: N f H kb o f i n
MAILING ADDRESS:
CITY:
PHONE:
90n W market
5 poltu AP,
cOS - ti -`79103
CONTRACTOR LICENSE NO.:
STATE:
Lin
ZIP:.
FAX: CELL:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
El Tear Off tt Overlay
TOTAL COST OF PROJECT: $
0.32 • av
IMEq
Thehepermitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling Is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The slgnatory is the property
owner or has permissio • represen tte-property owner in this transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Devel•• -nt cod ( Ref ��renced cotes are available for review at the City of Spokane Valley Permit Center. 5). The City of
Spokane Valley perm is of a pefmit approval (or any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be -q ed to b6 su tted and s sequently approved before this application can be processed.
Signature
Date: (�
/y
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-I1-11.doc