2016, 04-07 Permit App: BLD-2016-1142 Re-Roof ii▪ iE I`ut 10 UI.0 la flipiri 1,Ur 1511UULIUII .�VoY
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j Community Development Department ' - • • •
• Permit Center (Staff Use Only)
Scar0�;,.,,�� 11703 East Sprague 99205e,91 to 5-3�t((� Spokane valley,WA 99206 i PERMIT NuMgot: ••
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....*Valley- Tel: (509)688-0036
Far: (509)668-0037 PERMIT FEE:
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REROOF CONSTRUCTION PERMIT APPLICATION
El COMMERCIAL E• •ESIDENTIAL ect
SITE ADDRESS: Ca•`\ % o N cA. RECEIVED
ASSESSORS PARCEL NO.: LEGAL DES • IPTION.
APR 072016
BUILDING OWNER NAME:
MIII=Ir
M1FAMf: c� s S CSV PERMIT CENTER
ADDRESS: 1 RFV #
CITY: STATE: ZIP;
PHONE: FAX CELL: .
CONTACT NAME: 0 A 12, i U 5 f2_ P r(E
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PtiUN E: FAX: CELL:
CONTRACTOR NAME: AL P t i1/4.I L CO"-) S i !2 C.- I S
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MAILCNG ADDRESS: ("j IH 1 9 G C7 Le;.t 1\4 /6,-- /2- C �) (Z.
CITY: Poi k .As%� STATE:LA
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PHONE: (4 - u 1'r
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COdTRACTOR LICENSE No.:A L P i,...) C o SreLPIEXPIRrs: I o/3 /1 3 CM(BUSINESS LICENSE NO,: Ti 2.00 337 I +3 V S
DESCRIBE THE SCOPE OF WORK IN DETAIL AND Ih DICATE USE:
Tear Off — In Overlay
TOTAL COST OF PROJECT: $ S 3 c�v
DISCLAIMER
Tne permitted verifies,acknowledges and agrees by their signature that: 1)if th16 permit Is For construction or on a dwelling,the dwelling Is/wlll
be served by potab:e water. 2)Ownership of this City of Spokane Valley permit num to the property owner, 3) The signatory fs the property
owner or has permission to represent the property owner in this transaction. 4) PO construction Is to be done in roll compliance with the City or
Spokane Valley development code. Referenced codes are available for review at the Ory of Spokane Valley Permit Center_ 5) The City of
Spokane Valley perms, Is not a permit or approval fo ny violation of federal, sate or local laws,codes or ordinances. 6) Plans or additional
Information bray be re ulred to be submitted and sup- quently approved before i'ls application can be processed.
Signature Date: V/ ) / / 6
Updated 1-11-L1 Page 1 of 1
http://www.spokanevaliey.org/6lestorage/124/931/210/948/1496/2743/Reno or.doc
Received Time Apr. 7. 2016 8: 09AM No, 3207