2014, 11-13 Permit App: BLD-2014-2756 Tear off, Reroof*Valley
Community Development Department
Permit Center • -�
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688-0036 7RO- 5,2510
Fax: (509) 688-0037
permitcenterespokanevalley.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL
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SITE ADDRESS: D C /
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ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION:
R E C E I V E U n
BUILDING OWNER NAME:
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NAME: LJ\�/� r -( �fL
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ADDRESS:1_1 /
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CITY:
STATE:
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SUB = I —ZIP: -
PHONE:
FAX:
CELL:
CONTACT NAME:
PHONE:
Fax:
CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
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CITY: V — /( i a L'4 / by'
PHONE: cool 0)2 1 sag /
STATE:
FAX: CELL:
ZIP: 9/Z / 2
SG)n -e
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
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TOTAL COST OF PROJECT: $ 5 L C 0
I 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 thls transaction. 4) All construction Is to be done In full compllance 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 bQ.svb» fitted and subsequently approved before thls application can be processed.
Signature
Date:
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Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/2743/Reroof.doc