2013, 08-21 Permit App: BLD-2013-1655 Tear Off, ReroofSpokane_aostyp�T'
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Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley,' WA 99206
(509)688-0036 FAX: (509)688-0037
www.sookanevallev.org
Reroof Construction
Permit Application
3Lb- 2ok3- W
PERMI'.T NUMBER:
PERMIT FEE:
4 115.75
tn COPY❑ comm
cial
esidential
SITE ADDRESS:
ASSESSORS PARCEL NO:
5520 e MORA
Building Owncr:
Cuotractor:
BE r• lid
Name:'
ct 4o21Ub etAtecThsiit, TAIC.
Address: a 5 2.0 try
Phone: dor 11, 3 .O5 / Fax:
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Address:
05 Rx3, r --1 I. "1 A11811111111111111.111.111a
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City. . V CP.11vr� State: iDJ,c Zip: q \rg,
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Phoue:it$ 3_ '-1,16b Fax: ,1 1'5( 3 '° it
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ContractortoLic No?ozwem 3xpela:
Q ..r..3 . ori
Contact Person
City Business Lic. No:
bc�
Name: 3
Phone: ct4l ^c \ai 3
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,scribe the scope of work in det
Tear off
❑ Overlay
Cost of project: $
e ermltrities, acknowledges -nd agrees by their signature that 1) If this permit is for construction of or on a
dwel Ing, a 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) This 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.
Ownership of resulting development rights granted by any Issued permit inure to the property owner.
Signature
Method of Payment:
❑ Cash
❑ Check
Bankcard #: - REDAi T E
Authorized Signature. - -
REVISED e/232005
t
❑ Mastercard
Date
capires: REDACTED VIN#:
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.