2011, 06-02 Permit App: 11001552 ReroofSpokane
03,\$...s
4,0•10Valley°
Community Development Department
Permit Center
1i703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 638-0035
Fax: (509) 688-0037 . R
permltcenterespokanevall
sus
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE: 5 f f 5: `7S /,
REROOF CONSTRUCTION PERMIT APPLICATION •
CI COMMERCIAL
SITE ADDRESS:
RESIDENTIAL
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: k t,b (1 S rr t(te GGianez-
ADDRESS:
3i 4.5 S nGi.Q to t'1
CLrv;
PHONE:
Spt*J1\l() e
STATE: WA,
ZIP: G'4 I2
FAX:
CELL;
CONTACT NAME:
PHONE:
FAX:
CELL:
CONTRACTOR NAME: I y a aoj s 6
MAILING ADDRESS: 55 a$ a s9Cy� - �ve.
. CITY: Spp,n� V�t�e "Y, u
PHONE: 5Qci• S1ts6 " s(o
SPATE: W Pd ZIP:' "I L'1. d'Z.
FAX! 50q.,S3-''{(3o' CELL:
ugl
CONTRACTOR LICENSE i N LANR.SO'4 iJA EXPIRES! CITY BUSINESS LICENSE NO.: (01,1 `16 i i'
DESCRIBE THE SCOPE OF WORK IN DETAIL AND IINDICATE USE: •
t24;(-ne lTt' rooF i2e. Qo .
gi Tear Off
TOTAL COST OF PROJECT: $ U c se,. 00
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 Clty 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 Devetopment code, Referenced codes are available for review at the Clty of Spokane Valley Permit Center. 5). The City of
Spokane Valley permit Is not a permit or approval for any violation offederai, state at- local laws, codes or ordinances. 6) Plans or additional
Information may be required to be submitted and subsequ fitly approved before this application can be processed.
Overlay =
Signature
Date: 6tl(1
Updated 1--1111 Page 1 of 1
http://www.spokanevalley.org/filestorage/1I4(938J210/948/1496/Reroof PermIt_1-11411.doc
Received Time Jun. 1. 2011 9:22AM No.2702