2013, 09-13 Permit App: BLD-2013-1859 RE-Roof •
g ."'°� Community Development Department
..,' ,`,, i Permit[Center (Staff Use Only)
SUR Wu `' 11703 East Sprague Avenue, Suite 6-3
poka'ne Spokane Valley,WA 99206 PERMIT NUMBER:
ValleyTel::(50(5099))688-0036Fll688-0037� PERMIT FEE:
4000.
per111itC�rlfpCCUS2ISa i 1<Ks�ILe�C.lt1'4
REROOF CONSTRUCTION P RMIT APPLICATION
0 COMMERCIALI/T:[�•�,� SIDENTIAL j (,
SITE ADDRESS: (. V h
2N -1 9 ( T
ASSESSORS PARCEL NO.: 11 LEGAL DESCRIPTION: ' (/
BUILDING OWNER NAME: 1 �i Q 1.9
NAME: A Je5 I
ADDRESS: dilf,i
CITY: --.‘ •, STATE: ZIP: -
PHONE: ) , . C/ri I FAX: CELL:
CONTACT NAME: .
PHONE: I FAX: CELL:
•
CONTRACTOR NAME: I /1 .
MAILING ADDRESS:
��R G CO ...—
CITY: 1 POBOX 7174 STATE: _._._ _. ZIP:
PNONE7
9$3 -1 IMO 1 SPOKANE WA 99207 •
I�1' tltl FAX: CELL: . .
CONTRACTOR LICENSE NO.: �E11_i9 , ftAXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE;
v
IN 0 1,..b_ e6.15
At:r Off iQ3 Overlay
TOTAL COST OF PROJECT: $ 1 I � t 0C------
l _
pYSCLAzih R
The permitted verifies,acknowledtie6 and agrees by th it signature that; 1) if this per mit Is for constriction nr one 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 N 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 cudcy arc available fur review at the City of Spukdnc Willey Pei mil Center. 5) The City or
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
4
information may be required to be Subiirilted and subsequently approved before this application can be processed.
Signature 1 Date: 7 /— I 3 -13
c________:_____
6 - .9--ol -1 g69
irl."---
Updated 1-11-11 � Page 1 of 1
http://www.spokanevalley.org/filestorage/121/938/210/948/1496/R roof Permit_1-11-11.doc
T/T'd L200889j01 90TL28t7 9NIJOON GrION3eN3d:wood 8T:ST £TO2-2T-d