2013, 10-28 Permit App: BLD-2013-2221 Tear Off, Reroof lift Community Develapmenl Department
Permit Center
.� (Staff Use Only)
Sikikane 1 1703 East Sprague Avenue, Suite B 3
Spokane Valley, WA 9920(r PERMIT NUMBER:_
v
ley . rel: (509) 688 .
Cax: (509) G88-00.37 PERMIT FEE:
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_. REROOF CONSTRUCTION PERMIT APPLICATION
] COMMERCIAL' D�NTY#AL
SITE ADDRESS:G OO 5 �A(,� ro�ect YJL-r• w i �- 2- ' 1
ASSESSORS PARCEL. NO.: LEGAL DESCRIPTION: REGE' E
BUILDING OWNER NAME: ,_..8.0.370tBU OCT 2 8_ 20 ,
NAME: A.} \ 4 B V ici, I
X ��'Jam_ - CSS R€RMIT-CENT"€R
ADDRESS: - -
-S U B # ffrl R V --�
CXTY: STATE: Ip; -
PHONE: — FAX:FAX: CELL:
CONTACT NAME: j1:3
PHONE:c 1C '55 I 3
4_ FAX: CELL:
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CONTRACTOR NAME:? EA OO b "Kb O F-___ 1.1 1,4 c_... --
MAILING ADDRESS: 9. 0 • 'i30). --1 ` 7
CITY: -5.90V.$0.1 C STATE: W ZIP: 1 cia O i
PHONE; ‘50Ci ' 4-S3 ' 1 I FAX: CELL:
44553 — l� 1 03 _ •
CONTRACTOR LICENSE NO.;?C egettCC4 EXPIRES: CITY BUSINESS LICENSE NO.:DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: _
,e� :.11 ear Off . Overlay
AL COST OF PROJECT. $ �j✓ C� CQ • t.J/� --- .. ---- - _._ - --
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fire permitted verlf,-, ackpowlenp._y and agree::uy their signrrure that: 1)if Chis purrrtlt 15 for conStiuc:tion or On a dwelling, rhe LIwcllrng IS/w:',.
be c.elvod by potable water. ?)Ownership or chis Clty of.spukane Velley per mit inure to the property owner. y) Tire signatory is the prei,r ..v
owner Of iias permission to Icpreserrt the wooer-1:y owns-in this tr•ansarrlun. 4) All cnn,-.truction Is to be done in full compliance vvilh the City cf
Spokane Valley Development code keforenced codes are aviit..mhlr_ for review nl the city of spoicemc Vailey Permit Cenl:cr 5) The LILY •,1
Spokane Valley permit is riot en permit of .pprnvol for any violation of federal, ;Cute or local I,aw•_, codes or ordrnaiice . o) Plans or acItUri,,nai
Information may be required to be submitted and Suh-.rqucntly approvr.cl before this applic.ition can be procr:;ied.
Signature Date: /0 i!
i1
1pdaiecl -11.-11 ---- — — _
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