2014, 10-20 Permit App: BLD-2014-2572 Tear Off, Reroof5�101�aI1� e �
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@sookanevallev.org
Project # 8P '2E4* ?E-
r
(Staff(�Use Only)
PERMIT NULL 2 0 2014
PERMEtFr
SUB # / REV. #
REROOF CONSTRUCTION PERMIT ION
❑ COMMERCIAL R RESIDENTIAL
SITE ADDRESS: /OO.S /% GdC t�
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: /?..SS a A-1)77 /cc?,Se/re
NAME:
ADDRESS:
/DOS— n GoC 4s�
Om ) CA ---a_ _ ,4 4 STATE: 2(
PHONE: S o? -?:02 o - On/,4 FAX: CELL:
CONTACT NAME: %JI cm SC ‘C. -r £E'
ZIP:
171.20, 6
PHONE: ?-)
CONTRACTOR NAME:
Sas 2.30 r3/C
FAX: CELL: //
4 - o7 /7 -c am fJvr) /S
-40e cp
MAILING ADDRESS: Sin
CITY:
PHONE:
STATE:
�C ZIP: ?ri27.�
/�`y/�efr 0/)3 FAX: �ot ir0/2(-
f CELL:
CONTRACTOR LICENSE No.:
sol 2-30 .5-3/0P-
CONTRACTOR
3/cF
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
%Tear Off
TOTAL COST OF PROJECT: $ t5 ,R S V
❑ Overlay
DISCLAIMER
The permitted 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 thls City of Spokane Valley permit Inure to the 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 are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any vi. Ion of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required . .:, tted ubspproved before this application can be processed.
Signature
Date: /ZS Ij04C/
Updated 1-11-11 Page 1 of 1
http://www.spoka nevalley.org/filestorage/124/938/210/948/1496/2743/Reroof.doc