2016, 02-23 Permit App: BLD-2016-0507 Re-Roof — -- -- No. MN r 1 '
Jun. 1. 2011 8:51 AM . Spokane Community Development Department (Stat(Use Only)
Permit Center Suite B-3
sct'fy 11703 e V Sprague Avenue,
o. Spokane Valley,WA 99206 PERMIT NUMBER:
•
Valley Tel: (509)68B-0036 FaDERM1 C Fe�i
x: (509)688-0037
440000
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REROOF CONSTRUCTION PERMIT APPLICATION
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121 COMMERCIAL .1 RESIDENTIAL .
Project -�� " ,C), )7SITE ADDRESS: ��� � LEGAL DESCRIPTION: R_F C E'I V'E (�.
ASSESSORS PARCEL NO.:
BUILDING, OWNER NAME. I
. ( e Or
NAME: _ — RAt•
CSV'PE
ADDREF90 1�I2� -i •-� R.MIT C'i=NTER 1
STATE: \ Ir SUB # zf P'
CITY: - __
FAX: CELL: •.
pNON�3
CONTACT NAME:
PHONE:
FAX: tell:.
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CONTRACTOR NAME: xh\C e OO f 1 S�,Lppk t'Shc. .
.
' MAYL7IN13 ADDRt:SSI 55 a a ve.
CITY: Se K.lO.nE. ya,tkic.S STAT!) \A)A . .ZIP:. 4um,
PNONE: 509'S.3 f, t$(" FAX 5Q4_533-g1Ir30 , CELL:
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CONTRACTOR LICeNse NOS! IN LAN RSO44JA CXPIRCS: CITY RusiNESS LICENSE No.: (eO( ‘11 to 1.144
p'SCRIDE THE SCOPE Of WORK IN DETAIL AND INDICATE USE: .
D - C ''' .ai
•
Tear Off —
Overlay
TOTAL COST OF PROJECT: $ (0,13 0. 00 % S ILI 3--75
DISCLAMER or
The oermitted verifies,acknowledges and agrees by their signature that: 1)If this permit Is for constructioner on dwelling,
, trie dwelling
is/wtti
be served by potable water, 2)Ownership of this City of Spokane Valley permit Inure to the property o ) Tda a property
owner or has permission to represent the property owner In this transaction. 4) All•Construction Is to be done In full compliance wien the City or
Spokane verity Development code. Referenced codes are available for review et the City of Spokane Valley Permit Center. 5)• The City of
Spokane Valley permit Is not a permit or approval for any violation or federal Siete or local laws,codes or ordinances. 6) Plans or additional
Information may be require to be ubmitted a bsequ . ' rorr this anpllcatlon can be proceeded.
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Signature - Date: 'DWI ifo
V. .:".. ......'----....---";:--"----.------.------ ---1.:e_____,
Page lofl .
Updated 1-11-11
htto://www.sDokanevelley.Org/filestOrage/124/938/210/949/1936/Reroof_PermIU-11-i1 Alec
Received Time Feb. 23. 2016 10: 21A1 No. 2966