2016, 03-23 Permit App: BLD-2016-0982 Re-Roof .,,,, Om..1V Aml. w--�-- No. 'l IUU r. I
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Jun. I. 1011 S•51AM . Spokane Valley t'ermit Centel
•
community Oeveloprnent Department (Staff U$ Only)permit Center
11703 East PO WA 99206Sue B-3 PERMIT NtIMDER:
Sj5óJi1LeTel:one(50 )Gley,
TeL (509)688-0036 DERMI'f FEE:
Valley. Fax:
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OOF CONSTRUCTION PERMIT APPLICATtO
RRER ~ __
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- — — -
23RESIDENTIAL
al COMMERCIAL 2 8 `3
SITE ADDRESS: 131 7,3 e
ASSESSORS PARCEL NO.:
LEGAL DESCRIPTION:
_ .—_ .. v t. . ! l L NTEW
BUILDING OWNER NAME: �. .
��AA
NAME: �++ 6(Q IY 11�1.r��--`'f�@n .� - I
ADDht3t3S: `13� •
-- t,�Q, ZIP: gq��10
GxTY:
QO1 to •• Valli-4i_ STATE: �V'�
FAX! CELL:
PHONE: .
.rte_
CONTACT NAME: - _
FAX: •
CELL:PHONe. • -
CONTRACTOR xrti\4r �e0A,a.i Supp -Lh4 . ' - . '
MAILING AODRCSS: 55 a G so-45 t'`�- A'z° • . •
CITY:
SIAM: \A _ ZIP:
.1. . . .
PAX) • r -,q(41 I) CELL:
CONI ACTOR LTCENSH No'.: 1N LAN ASO4NJA CKv1Al?5: CITY BUSINESS LICENSE NO.: 40 I 4•110A'��
DESCRIDE T11E SCOPE Of WORK IN DETAIL AND INDICATE USE: .
DTear Off � -�
it Overlay
TOTAL COST OF PROJECT: $ £' lb,ciBgs.ck /y3,1�
DISCLAIMERonnstrychan or on a
The permitted verifies,acknowledges and agrees by their signature that: 1)if tis permit Is
to for
e property owner.3) The shag,snathe
d Leel property i
be served by potable water, 2)Ownership of this City of Spokane Valley p
ert owner or Ms permission to represent the property owner In this transaction. 4) All.construCtlon Is to be cone in full compliance with the City of
Spokane Valley Development coda. Referenced collet are available for review at the City of Spokane Valley Permit Center. 5). The City of
nformatt Volley
be requiredtto be mit or approval for any submitted and subsequently al °roved before this application can be processetion of federal, state or local laws,codes or d. 6) Plans or additional
Signatur C7In .1�441,* Date: -31 31/(v
_ Page 1 of 1
Updated 1-11-11
h ttowwww.sookanevalley.org/filestorege/1z4/938/l].0/948/1496/Reroof_Dermlt,.1 11-11.doc
Received Time Mar, 28. 2016 9: 21AM No. 3154