2013, 03-28 Permit App: BLD-2013-0531 ReroofSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@sookanevallev.org
(Staff Use Only)
PERMIT NUMBER: L�
PERMIT FEE: •' i / / 1 7✓
REROOF CONSTRUCTION PERMIT APPLICATION
❑! COMMERCIAL tst RESIDENTIAL
SITE ADDRESS: 2j Z2- ` I) �� 1 k. 12'
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME:
ADDRESS:
CITY:
STATE: Zip:
PHONE:
FAX: CELL:
CONTACT NAME:
PHONE:
CONTRACTOR NAME: Spo
MAILING ADDRESS: t
FAX: CELL:
2—
CITY:
PHONE:
GD'°1. -- 7\.
FAX:
STATE: V�
CELL:
ZIP:.
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off
OTAL COST OF PROJECT: $
q000
❑ Overlay
DISCLAIMER '
The permitted verifies, acknowledges and agrees by their signature that: 1) if this 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 Devei.. ment co. - : - erenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit 's not a permit or ap. .val for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be r -q ire. • ie ub itted a' d subsequently approved before this application can be processed.
Signature
Date:
�Oj• C;
2 3 2013
Updated 1-11-11
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc
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