2013, 09-11 Permit App: BLD-2013-1820 Re-Roof Permit Center
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11703E Sprague Ave, uitc B-3
Spokane Valley,WA 93206 PF.R.MTT FRE: '01 3 •.
,0Valley. (509)688-0036 FAX:(509)688-0037
www.spokanevalley_rns
Community Development CO
PY Commercial
Reroof
Construction
Permit Application `'El Residential
SU E ADDRESS: 4 BZ-0 Ivy iE -- ?-4-D 90012LI;(4 ' '
o 5'58
ASSESSORS PARCEL NO:
Building Owner: Contractor:
Name: Name:
Address: Address: o --, `'°(1,L.
Po1�f Tao
City: State: Zip: City: State: (6 Zip: ��aa
Phone: Lf, Phone: ,g 3- Toe:. Fax: 4q,.3 -1(0(4,
• Contractor Lie NorD _ Exp Date: t _ _ -1
Contact PersO City Business Lic.No:
Name: 06
Phone: q79 - •?
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Sbescnbe the scope of work in de '1: Tear off 0 Overlay
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Cost of project: i r 2,7 I , 0 S.----"'
' yes,acknowledges and agrees by their signature that 1) If this permit is for construction of 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 clone 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) This City of Spokane Valley
Permit is not a permit or approval for any violatic n 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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Signature Date
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard VISA
Bankcard#: REDACTED Expires. REACTED VIN#:
REED
Authorized Sign,
REVISEDB23r2ocs This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
(....._____ _ Nil°
and the original document destroyed pursuant to SOS DAN
G52014-030.
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