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2014, 07-02 Permit App: BLD-2014-1553 Reroof • Project �'1�'-2o1 i�S 3 ..g . RECEIVE © �j� Community Development Department n "� Permit Center JUisih I Vnly) Spol�ane0."\ 11703 East Sprague Avenue, Suite B-3 Spokane Valley,WA 99206 PERMIT UM R' ValleTel: (509) 688-0036 ;S V P f= M t.N...„. V T E R Fax: (509) 688 0037 PERMIT,FEE: permitcenter@spokanevalley.orq SUB t_ J , P'`1 TTY REROOF CONSTRUCTION PERMIT APPLICATION ❑ COMMERCIAL 49(// RESIDENTIAL SITE ADDRESS: a yt,�, S_ V �!'t.sJ 1( ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: �jp_ ,I-6A4y (-cad=,�. ,.) NAME: ADDRESS: CITY: STATE: ZIP: PHONE: FAX: CELL: CONTACT NAME: PHONE: FAX: CELL: CONTRACTOR NAME: 615#1(k.); ihtli'j i;h tnAi tL MAILING ADDRESS: /d( 11/•• 64 Y7` '2 CITY; _ tt STATE: �70 ZIP: PHONE: 8. a 7 a 33 z /', FAX: CELL: CONTRACTOR LICENSE NO.:C in f"'I-t 0 7/ 't' XPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: /SRO F 4 o►Lc 4,-V 4- kot c4-"A-5-6 Tear Off IS) Overlay TOTAL COST OF PROJECT: $ lF5 D 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 per is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information mayb r quired to be submi d and subsequently approved before this application can be processed. Signature / ;'"`. ----- Date: Method of pgyment: 0 Cash , 0 Check 0 Visa 0 Mastercard Bankcard #: EXP: VIN#: Authorized Signature: Effective October 28, 2007 Page 1 of 1 P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Reroof Construction Permit App 10.28.07.doc