2013, 05-14 Permit App: BLD-2013-0872 Tear Off, Reroof5iy 1413 11:39a
Spokane Roofing
Spokane
Valley
Project u 81C1—(3 Z_
RECEIVED
Community DVe}dpnle/tt (2Waltment
Permit Center
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Cn
S3oaneVSJr R942d6 CIV
Tel: (509; C188-m.16i
FS)l:) (45p8-7031
REV. tt
747-8990 p.1
r
COPY
(Staff Use Only)
PERMIT NUMBER: /J�
(ERMIT FEE: /61)-7 ' 17 5
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIALc�
SITE ADDRESS: 1U.-ICR F
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
RESIDENTIAL
LEGAL DESCRIPTION:
NAME:
ADDRESS:
Cm:
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 G52014-030.
STATE:
ZIP:
PHONE:
FAX:
CELL:
CONTACT NAME:
PHONE: n
CONTRACTOR NAME: vDsCr,i_ QLD '1\a CC
1 J
FAX:
CELL:
MAILING ADDRESS: \ 5O C' c 1-L'�Nt ' tilt
Cm:
STATE:
WA
ZIP:
PHONE: c f.i
fi — f137 FAX: C' R f — 1 —4!
1 1)
CONTRACTOR LICENSE No,:CLIVAQ0,0 4/e .ix EXPIRES:
CELL:
CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
, Tear Off
TOTAL COST OF PROJECT: $ c"'
❑ Overlay
DISCLAIMER
zee
Tneflea-, permdied ver fle, acknowied;es and agrees ay mei: signature that. 1) d this permit s (o- construction or on a duel :no, the
dwelling the pens
;a-:eC by potaole water. 2) Ownership of this City of Spokane Valley permit Inure 10 the property owner. 3) — sisnt o
"...mar or las permiss:on :0 'epresent one property owner in this transaction. 4) All construction is to be done in NII compliance with the C tv of
Spa c313 Varey Development ode. Referenced codes ar ave ladle for review at the City of Spokane 7aliey Permit Center. 5) Tne Cty of
7t gene VeIIep pe -mit rata perm[ .a proval for a y y aI3tlon of fed=-ra, state or local laws, codes or orcinances. 6) an; or aoait:ona.
'r:r:rat:or r(a y =e roue de sub t ed and sub) uen;ly approved :efore this application can Ce processed.
Date: 1:2-lk/
Signature
Method of pym t: ] Cas`-- "t Check
(a
l;
Bankcard a. ,.
Autrerize0 Sigiature:
EDACTE3
L
1
isa ❑ Mastercard
EXP: RgDACTED VIvf:
Pagel c!
Effective October 26, 2007
_: •Communrty Dev&opment\O2 Administration\03 Forrns - .07 idoc ersions\Permit Center\RerOCf Construction Per mit App