2013, 10-24 Permit App: BLD-2013-2192 ReroofCI7YOF
Spokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688 0030 1O
Fax: (509) 688-0037
oermitcenterc spokanevaIlev.orq
i
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
Ei COMMERCIAL f �r ij RESIDENTIAL
SITE ADDRESS: l G.' IC.'
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: -3-'0(A y\e k (Th_
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
PHONE:
FAX: CELL:
CONTACT NAME:
PHONE:
CONTRACTOR NAME: r . •k,1, Com=' CCti(J
FAX: CELL:
LLL.
MAILING ADDRESS: ). (% \
ii STATE:.ZIP:•
CITY: alLti�-c 1%U,i1�.7� L1/4...)k 9g a r/�a�({ (�
PHONE: 5 -3-) O - O b )I V FAX: So CI a_'" C75 ) CELL: 50 te• 3') O O E I v
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF,WORK IN RETAIL AND INDICATE USE:
Roo-'• 6..)/ -4-CIX 6
Tear Off
TOTAL COST OF PROJECT: $ C/j300
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 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 oY 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 Vubsequently approved before this application can be processed.
Signature
)1's
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc