2016, 03-10 Permit App: BLD-2016-0749 Re-Roof ■_3r 1 U lb 1 U:P4a Alpine Uonstructlon :w�-r-V+0-ow9. N. I ,
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■ Sep. 27. 2013 1Q:44AM 1 iv El. 7610.2,;:e16 //q
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ion .4 - Community Development Dern. ent t V t
Permit Center (Staff Usti lye
cm' e 11703 East Sprague Avenue,s I e B-3
Spokane Valley,WA 99206 ! PERMIT NUMBER:
S
....Valley-
Tel: (509)688-0036 mho, I U 2016
'1�� �D Perr (509) 688-0037 PERMIT FEE:
.Si 1�+ permjtcelt�r(� okan�vai(Qv.o , rCf MIT CC TER
REROOF CONSTRUCTION P NIT APPLICATION I REV. # f—`
Et COMMERCIAL E !RESIDENTIAL
SITE ADDRESS: `-{ H S A-A c-- b<s'..1 i. L
ASSESSORS PARCEL NO.: LEGAL DES • PTION:
BUILDING OWNER NAME: ..
NAME! v L n` i•-,>I _
ADDRESS:
I
Cl :
STATE:
rr 'I ZIP:
PHONE:
FAX: CELL:
CONTACT NAME: D A CL i 5 1L P PE'
PHONE: FAX: CELL:
CONTRACTOR NAME: ALP I iV I✓ L 0 N S i -`-' L a 1 0
MAILING ADDRESS: L'! L1 l 9 ( C'7 L. -i M ,4 t 4 Q g-.
CITY: Po k(Al' G St ,T \ATE: !-. ZIP: Q 9 Z 3
I. Ca
PHONE` LI ` - (- Q Ci. FAX! `7 "t ' S S c LH CELL!
CONTRACT-OR LICENSE NO.:ALP 1 N c-kc c t3 SaarJE ci i os= i 0/ • /i 3 CITY'BUSINESS LICENSE NO.: 7-, Z0 0 3 3,1 (3 u S
DESCRIBE THE SCOPE OF WORK IN DETAIL AND I .ICATE USE:
Tear Off ITI Overlay
TOTAL COST OF PROJECT:ECT: $ / , 2�Sr
DISCLA7 ER
Trio permitted venires,acknowledges and agrees by their signature that: 1)if t 14 permit Is for construction or on a dwelling,the dwelling is/will
be served by potable water. 2)Ownership or this City of Spokane Valley perm t inure to the property owner. 3) The signatory Is the property
owner or has permission to represent the property owner In this transaction. 4 411 construction Is to be done in Foil compliance with the Oty or
Spokane Valley Development cone. Referenced codes are available for review at tate dity of Spokane Valley Permit Center. 5) The City of .
Spokane Valley perml_is not a permit or approval for ny vlolation of federal. tate or local laws,codes or ordinances. 6) Plans or additional
Information may be re fired to be submitted and su S vently approved befor/ ells appiication can be processed.
ii c' If
Signature Date: 3 b
Updated 1-11-11 Page 1 of 1
ht:tp://www_spokanevalley.org/filestorage/124/9[f 3/210/948/1496/2743/ReraoF.doc
Received Time Mar. 10. 2016 10: 14AM No. 3049