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2011, 06-13 Permit App: 11001711 Tear Off, Reroof Community Development Department Permit Center (Staff Use Only) SCITYOt 'Y 11703 East Sprague Avenue, Suite B 3 pokane Spokane Valley, WA 99206 PERMIT NUMBEN .1 in 171 I Tel: (509) 688-00361` S Valley. Fax: (509) 688-0037 PERMIT FEE: permitcenter@spoka neva 1lev.orq REROOF CONSTRUCTION PE IT APPLICATION 0 COMMERCIAL dilii RESIDENTIAL SITE ADDRESS: S 0 C A. 5 ,�w© ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: ADDRESS: CITY: STATE: ZIP: PHONE: FAX: CELL: CONTACT NAME: PHONE: FAX: CELL: JTi1' CONTRACTOR NAME: CdhS 1,t, /"o&' MAILING ADDRESS: (7(1 �_ �.,`r,ce It, CITY: S p k..0 vt. STATE: ""// ZIP:.7 , #2--/7 PHONE: FAX: CELL: CONTRACTOR LICENSE No.: 144 5 yvt L C/if 13eXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THESCOPE OF WORK IN DETAIL AND INDICATE USE: --k. c4 / v.� r e,6-f= ear Off 0 Overlay TOTAL COST OF PROJECT: $ I eLiD 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 be sub ed and subsequently approved before this application can be processed. ---7Signature arl Date: / /i/ Updated 1-11-11 Page 1 of 1 http://www.spokaneva I ley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc