2011, 09-12 Permit App: 11002810 Tear Off, Reroof `'". Community Development Department
•r Permit Center (Staff Use Only)
SiclTyor 11703 East Sprague Avenue, Suite B-3
pokane Spokane Valley, WA 99206 PERMIT NUMBER: / ( -z-7J (0
Valley Tel: (509) 688-0036 I
415.
Fax: (509) 688-0037 PERMIT FEE: 1 5-, 7
permitcenter@spokanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
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ASSESSORS PARCEL NO.: YS)7 1. jbzy LEGAL DESCRIPTION:
ZNG;OWNER NAME: //:(J .//?/i G_ �T/�e-fLU
NAME:
ADDRESS: //.j ,4//anfWCley � C S`6�()/C I rZL� 9Zi Z
CITY: ` ipok,r Alt./i6,.- STATE: YY4t ZIP: ,I9 jp
PHONE: 609 OZ.Z - 9203) FAX: CELL:
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: '
' MAILING ADDRESS: '
CITY: STATE: ZIP:.
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
BE/THE SCOPE OF WORK psi DETAIL
, ETAILAND INDICATE USE)
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DISCLAIMER &c, Y horde
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling,the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
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Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc