2011, 06-09 Permit App: 11001660 Tear OffSkikalfet\'`
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter sDokanevallev.orq
(Staff Use Only)
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PERMIT NUMBER: n
PERMIT FEE: / L9/ / T
REROOF CONSTRUCTION PERMIT APPLICATION
lg COMMERCIAL
l RESIDENTIAL
SITE ADDRESS: iJy� N 16 !J1.la)
ASSESSORS PARCEL NO.:4 t 4, n\( j EGAL DES RIPTION:
BUILDING OWNER NAME: AA,
NAME:
ADDRESS:
p,116 1 c• h y\tQ) Ye R-1-
f(Cried l.e �i KPR/f
v 4 "ti rig lam' , .5? l Y
CITY: line STATE: \�Y It ZIP: 01 4 (o
PHONE: J 1 q FAX: CELL:
CONTACT NAME: 4/' ' A I l �! , f i4D 666
PHONE: (iikm a S� 11 r1YY) FAX:
CONTRACTOR NAME:MCVAY BROTHERS
CELL:
(cdon16
MAILING ADDRESS:11420 E. MONTGOMERY
CITY:SPOKANE
STATE:WA Zxp:99206
PHONE:(509) 928-4686 FAx:(509) 252-2996 CELL:NIA
CONTRACTOR LICENSE No.:MCVAYBC346ME EXPIRES:N/A CITY BUSINESS LICENSE
No.:N/A
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
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LkL 2 -h c5n Rt%i Y
Tear Off
TOTAL COST OF PROJECT: $
El Overlay
DISCLAIMER
The permitted verifies, acknowled . -- 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 wat r. 2) • wn ip of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permissio to .e• - ent the pro wner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Devel ment code. Refe ced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley perm i is nota permit or pprovalt,for any violation of federal, state or local la •: • or ordinances. 6) Plans or additional
Information may be quired &o be sul$m' ed and Subsequently pproved before this applica can be p • cessed.
Signature
Date.(U11
Received Time"Jun. 8. 2011 .,4.,31,PM No.2824 Page1of1
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