2014, 03-13 Permit App: BLD-2014-0476 Tear Off, ReroofSpokane
4,;OValley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688 0030 720 -52V0
Fax: (509) 688-0037
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(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
Et COMMERCIAL •
SITE ADDRESS: 51( ;- N" 1— t -i'fit
RESIDENTIAL
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: r4eyec.i-(
0
NAME:
ADDRESS: 57i 9— Af LLuc]1 le
CITY: ?64 -et -4' i faf (
PHONE:
STATE: ZIP:
Fax: CELL:
CONTACT NAME:
PHONE: 50q 7/17 -97? -0 3 FAX: CELL:
CONTRACTOR NAME: 44 el vtnrce,74 J4
' MAILING ADDRESS:
CITY:
STATE: .ZIP:.
PHONE:
FAX: CELL:
CONTRACTOR LICENSE NO.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE $COPE OF WOR IN DETAIL AND INDICATE USE:
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Tear Off
TOTAL COST OF PROJECT: $
N 76-6
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 this 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 notaermit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required tosubmitted and subsequently approved before this application can be processed.
Signature
Updated 1-11-11
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc
Date: of/y/ir/
Project # ZLP y.2 O/4 —04
- RECEIVED
MAR 13 2014 -r fr
CSV PERMIT CENTER
SUB #! t REV .
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