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2015, 03-11 Permit App: BLD-2015-0455 Tear Off, ReroofSpokane Community Development Department Permit Center 11703 East Sprague Avenue, Suite 8-3 Spokane Valley, WA 99206 Tel: (509)-688-0036 73 4- 52 VO Fax: (509) 688-0037 permitcenter(alsookanevallev.orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: REROOF CONSTRUCTION PERMIT APPLICATION 1 COMMERCIAL RESIDENTIAL SITE ADDRESS: ` � ASSESSORS PARCEL NO.:1450-N cO). LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: ADDRESS: ?7o 0 ,v T V` o „ars Cm: PHONE: S/»Q- STATE: G. ZIP: FAX: CELL: CONTACT NAME: PHONE: FAX: CELL: CONTRACTOR NAME: G ry ✓ R u a ,C ; y 6 - MAILING ADDRESS: // :% 3 3 -LSO e4.- N J R 4. CITY: A 4 f 1i d r v r'- / f PHONE: J 0 CJ - aa, -7 tJ ! —7 u STATE: P U . ZIP: �3 dv- o FAX: CELL: CONTRACTOR LICENSE No.: C ( vim ,fr r C 'be) ~ 8EXPIRES: CJ ' ) ` / ' CIn BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: T-cr cI t< 2 ; I A.' tontt / 2 � o , ; ,& k [ et ; ,v 5.1-e f 9 IQ J. / ear Off TOTAL COST OF PROJECT: $ ? 7 o D tl Overlay DISCLAIMER The permitted verifies, acknowledges and agrees by their signature that: 1) If thls 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 qe submitted and subsequently approved before this application can be processed. Signature Date: J -7/ -7d -- Project -7/-/d— Project :1124--b- LOIS— SSS RECEIVED cacp MAR 1 1 2015 CSV PERMIT CENTER Updated 1-11-11 ri[V. & I http://www.spoka nevalley.org/filestorage/ 1 t4/9.i8/210/94811496/2743/Reroof:-doc Page 1 of 1