2014, 10-22 Permit App: BLD-2014-2588 Tear Off, ReroofSti I! ne
,valley.
Community Development Department
Permit Cente( '
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509)688-0036 -7A0-52VO
Fax: (509) 688-0037
permitcenter@spoka nevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
0 COMMERCIALRESIDENTIAL ^fin
SITE ADDRESS: /05/7 /2 l/SS/!l/v 4,ae• I Project X201 �i�j8
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: RECEIVED
BUILDING OWNER NAME: D)Q-h
NAME: EL Gt J. /1°1-(X S
ADDRESS: x/2)5/ 7 c- •`/w'
CITY: \. LCX2'tL C&/%/e//' //I%�/._CXlG-I STATE:
PHONE: i5 -2N- 9Y7 -�_4,7(cU/!� J FAX: /�
CONTACT NAME: EG/�Ca42/`Zet / Io//LLLU /, )6GGL��
PHONE: LJ /�
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CSV PERMIT CENTER
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FAX:
CELL:
609-95zct /70/
CONTRACTOR NAME: &J25
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX:
CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
(.4tac) h LA -02n and °2 .)
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TOTAL COST OF PROJECT: $
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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 mae required to be submitted and subsequently approved before this application can be processed.
Signatur
Date: /0002 420/ �.
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/2743/Reroof.doc