2012, 10-30 Permit App: BLD-2012-1971 Reroof./V J../aJJ JVJV
Jun, 1. 2011 8:51AM . Spokane Valley Permit Center
S�okanf er
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0096
Fax: (509) 688-0037
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1U.000UUJf
No. DUO r.
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(Staff Use Only)
PERMIT NUMB
PeAMIT Fee.
l 16-./tr.
REROOF CONSTRUCTION PERMIT APPLICATION
rz COMMERCIAL RESIDENTIAL
SITE ADDRESS; i (o I I 1 E Rare Dr.
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME!
ADORestse
G M 1 l,e_r
PO' 6.4 1501
CITY; Vt? ru t t2
MNo _20g gtt1-.2o20
CONTACT NAME:
STATE! W.A ZIP: qi:1 0 3!
FAX:
CELL!
PNONC -
FAX:
CELL:
CONTRACTOR NAME: SrtiWindt e OOftfrw + SwPPtiy %ex.
MARINO ADDRESS;
5S as B sprytI.Ae. Ave
Clry: SSaokyA."'_
• STATc.: A
PNowe: 504•$$ - 15(0
•
PARS ySDCty 5 2a,044 440 ceu.: •
ilei
CONTRACTOR LICENSE No.! 1NLANIRS01444JA EXPIRES: CITY fUSIN!SSLICENSENo.: (.01 (Air 114
DESCRYBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Z1P; 4 5i Lat
e
.fir► • I• It
SI Tear Off
TOTAL COST OF PROJECT: $ q5t>. ov
Overlay
DIICLAIMICR
The permitted verifies, acknowledges and agrees by their stpnature that: 1) it this permit te for construction or on a dwelling, the dwelling is/win
be served by potable water, a) Ownerattlp of this City of Spokane Valley permit Inure to the property owner. 3) 'Me atgn■tory la the property
owner or has permission to represent the property owner In this transaction. 4.) AIk.construction Is to he done In full complance with the CRy of
Spokane Valley D.vsoprn.At code. Referenced coded ah available for review at the Clty of Spokane Valley Permit Canter, 5) The City or
Spokane Valley permt Is not a permit or approval for any vlolaflon 01 federal, State or local IawS, Codes or ordinances. 6) plans or additional
information may be requlre4 td bJ submitted and subccque L1 approved Oct application CIO be processed.
Slgnatur
Date: 1012DLI
Updated 1-11-11. Page 3of 1
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