2013, 06-26 Permit App: BLD-2013-1227 ReroofPermit Center
11703 E Sprague Ave, Suite B-3
kalle Spokane Valley, WA 99206
4,,,„000Valleys (509)688-0036 FAX (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
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PERMIT NUMBER
PERMIT FEE: 1241 JO.
❑ Commercial
2 Residential
SITE ADDRESS: -7, a .
ASSESSORS PARCEL NO:
Building Owner.
Name:
Ve.OL!1 l CJI Se, v•---
Address-
--.3a.M_ 0.0ctibdike--
State: Zip:
City:
State:
Zip:
Phone:
Fax:
Contact Person
Name` s *IC) 04_4 In $'
Phone: r` 2
Contractor:
Morris Clark Siding & Rooting
Name: 2728 E. Garland
Spokane, WA 99207
Address: 4a2.2833
City:
State: Zip:
Phone: y9 079._.
Fa,c 7e0, S� %Q
Contractor Lic No:
Me 1W-r&SOCa:2-
Exp Date:0 ....1 6, __ . ti
a J1�
City Business Lia No:
Describe the scope of work in detail- Tear off 1 Overlav
Tv) SfLPJ. t.l % (-1 .wl A .r& a' -r)
Cost of project: S S3 40.4aD
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling istwill 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 nota 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 •
Bankcard #:
❑ Check
REDACT
Authorized Signature: , "
REVISED 8=035 ext."'
6'd OLZ9Z817605
Date
0 Mastercard '[' VISA
Expires: REDACT tl� 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.
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