2016, 03-02 Permit App: BLD-2016-0653 Re-Roof _ir uL 10 UJ. I Va mipine uonstruc uon OUy-440-0ou4 p. I
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%■ Communi ty Development Dept" Ent
Permit Center oS fresC m' D
sortikando.d.lie\lefte, 11703 East Sprague Avenue,Sc Ile B-3
Spokane Valley,WA 99Z06 PERMIT NuMeen: Br
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.....Valley
Tel:(509)688-0036 PERM-Ftp:
Fax: (509) 688-0037
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`,UT CENTER
REROOF CONSTRUCTION PERMIT APR-I A-T-01 ,, :: _ <
1111 COMMERCIAL RESIDENTIAL -----
SITE ADDRESS: k 3 3 1 3 L.k S S <' y
ASSESSORS PARCEL NO.: LEGAI.DESCIqPTIdN:
BUILDING OWNER NAME:
NAME: I`' \ A •. J Z A �y
Aooaess: _ _
CITY: STATE: .. ZIP:
PHONE: FAX: CELL:
I
CONTACT NAME: D AR... t o 5 R-A l� P G
PHONE: FAX: CELL:
CONTRACTOR NAME: A L P 1 iV L C 0 ^-1 5 c Imo-" y i c
MAILING ADDRESS: L.j L) i 9 L CI L E 4V M A-i 2 C Q f .
CITY: J P O (A i`-' C.• STATE: A Zw: 9 2-2_3
PHONE: u `• S q Cl FAX: `-I tl ca ' S S.( LI CELL'
CONTRACTOR LICENSE N O.:A I-P t N C- 0 S S.tt4eXPIRES: I o/34_7/' CITY BUSINESS EICENse No.: 7-l 2_‘,,,c 3 311 i3 us
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off (� in Overlay
TOTAL COST OF PROJECT: $ —"l IS L ' -
DISCLAIMER '1
The permitted verifies,acknowledges and agrees bV their signature that: 1)it tA1s permit Is For construction or on a dwelling,the dwelfing 15/wi:1
be served by potable water, 2)Ownership of this City of Spokane Valley perrr't inure to the property owner. 3) The signatory Is the property
owner or has permission to represent the property owner In this transaction. 4 kli constructlon Is to be done in tuft compliance with the OW of
Spokane Valley Development code. Referenced codes are available for rete a at the City of Spokane Valley Permit Center. 5) The City of .
Spokane Valley permit not a permit or approval For any latlon of federal, ;bate or local laws,codes or ordinances. 6) Plans or additional
Information may be req Ired to be submitted and subsequ n ly approved heron eras appiication can be arocessed.
Signature ,,......;:i Date: 3 /2._ // 6
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Updated 1-11-11 Page 1 of 1
http://wwwspoka nevatley.org/filestorage/124/33 3/2!0/948/149612743/Reroaf.doc
Received Time Mar. 2. 2016 8: 29AM No. 3002
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