2013, 06-24 Permit App: BLD-2013-1199 Tear Off, ReroofS`pok'ane
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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@spokanevallev.org
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
®❑ COMMERCIAL RESID
SITE ADDRESS: gql E dinD:;n
ASSESSORS PARCEL NO.: LEGAL DESCRIPTIO
BUILDING OWNER NAME: C
NAME:
l&ilee_ C .
ADDRESS:
CITY: STATE:
PHONE: FAX:
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CONTACT NAME: C'kr \
PHONE: ,SOC) SQ- 1 Mei soc3
FAX: r)1 / ZC3 2.C19
CELL:
CONTRACTOR NAME:
MAILING ADDRESS: 5�0 C gvAt,
Soo
PHONE: 5 b'3 9941 3011 -
CITY:
STATE: (4,1,_ ZIP: l f Z�Z
FAX:
9(2 -2Z
CELL:
CONTRACTOR LICENSE NO.: fAtt/`p}iLL, IZSWt2 EXPIRES: -2/21 /L01i 1 CITY BUSINESS LICENSE NO.: G>va 24-1S 209-
DESCRIBE^�!THE SCp7QPE OF WOR IN DETAIL ANDINDICATE USE:
4 1Prf nl{ dC2-S � (�con
Tear Off
TOTAL COST OF PROJECT: $COr000
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 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 approved before this application can be processed.
Signature a,.
Date{ 91V -A 1‘3
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc