2010, 12-11 Permit App: BLD-2012-2253 Tear Off, Reroof y Community Development Department
qty off Permit Center (Staff Use Only)
.
11703 East Sprague Avenue, Suite B-3
Spokane j
Spokane Valley, WA 99206 PERMIT NUMBER: /J 1 d-iZ'-2 Zr3
Tel: (509) 688-0036 �S
. Valley. Fax: (509) 688-0037 PERMIT FEE: 13_7 7XX
permitcenter@spokanevallev.orq
REROOF CONSTRUCTION PERMIT PPLICATTON
raJ�'ct #
0 COMMERCIAL
RESIDE TIAL RECEIVED
SITE ADDRESS: .....„6- O kq N
ASSESSORS PARCEL NO.: LEGAL DESCRIPTIO : r7-0-, '� f 2012
illBUILDING OWNER NAME: pAc e ":_yam n c_ �le.o,a 3�
� N
NAME: tl Ce R6 leC1 4 4.1 - � MIT CENTER
ADDRESS: ?OE— _Xa✓/(3' U REV, # -
CITY: S49 - STATE: ZIP: JO c
PHONE-6 / ^3~/^ C( FAX: CELL:
CONTACT NAME: RO b i77c O 41(
PHONE: FAX: ELL: o (./ — ! 6,6,
CONTRACTOR NAME: I.,/ . , 1'� c Z, e �t
MAILING ADDRESS: /?/0 - (/-‘e!41 * 7
CITY: 'eCtil� -STATEL4J ZIP:. q0
PHONE: C -e-(Q / FAX: �Z7 ef Z v 0 e CELL: ___50 1 x
CONTRACTOR LICENSE NO.:, LG(l 1'i'� EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THEAOP OF WORK IIDETAIL AND INDICATE USE:
XTe
ar Off ❑ Overlay
TOTAL COST OF PROJECT: $ .2 (fol, I
DISCLAIMER
The permitted verifies,acknowledges 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 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 done 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) The City of
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
information may be required to sebrrtid and,sabseque ly approved befog this application can be processed.
Signature �' ��
Date: k/-6,)
Updated 1-11-11 Page 1 of 1
http://www.spoka neva I ley.org/fi lestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc