2014, 08-18 Permit App: BLD-2014-1969 Tear Off, Reroof ;4D �° I_ ' / �-/'.
Community Development Department jr1
Permit Center (Staff/ s�
IP(3)844/J+N� D E
SCITY
dlOglilletNeellft 11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206 'ERMIT NUMBERj 201 4doll�ane
.o•OValley Tel: (509) 688-0036 AUG
Fax: (509) 688-0037 •ERMIT FEE:
permitcenter@spokanevallev.org
CSV PERM1 l utiN I CR-� �
REROOF CONSTRUCTION PERMIT AP • ._ . CATIO'`V1 REV. -= ---+
;
VCOMMERCIAL EI RESIDENTIAL
SITE ADDRESS: 1(q2, . Nnfil
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: •
NAME:; 4 e -//5 IJC //OW
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTACT NAME:
PHONE: FAX:: CELL:
CONTRACTOR NAME: 17,16? 7 I ym 4 /51.,4,,,,s,, ..
t�' ij
MAILING ADDRESS: 11 03 7i-ver.& ..
CITY: go JlGY7e STATE: V V/� • .ZIp:. ` 7�/G/t/7' o`
PHONE: -Sc' - g9S. �` 3L�D • FAX: • CELL: �0 ..". 7� 023``U
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DTeGi R',�HSi 5 ,co 1E pCOPE Of WORK/ IN to°ETA1 rf 0 r 1/6%e (00L ityw INDICATE USE:1
Tear Off 1.' Overlay
TOTAL COST OF PROJECT: $ j, ?co
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 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.
Signature /// Date: �`'/5--a0Jd�
l
Updated 1-11-11 Page 1 of 1
http://www.spoka neva)ley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc