2013, 10-09 Permit App: BLD-2013-2080 Reroof*Wane
-Va11ey6j
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel; (509) 688-0036
Fux: (509) 688-0037
yerali rater@spokanevaflay.oro.
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L.(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL 4312_ 11 RESIDENTIAL
SITE ADDRESS: N 0 ?I—O441)
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: ri\PtDDVK-
ADDRESS: 43\1— VL.. N\ `).c4- ID
CITY:
STATE: W
PHONE: 1 `Q?S - 499
/ ZIP:99A 1 p
FAX: CELL:
CONTACT NAME: J Q(
PHONE: / FAX:
CONTRACTOR NAME:
CELL:
MAILING ADDRESS:
Crry: PO BOX 7174
PHONE• SPOKANE WA99207 FAX: CELL;
PEFIFILNOUb ROOFING' CO
STATE: ZIP:.
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DET IL AND INDICATE USE: I �r�W
_tri cJ N earef
?<1.2'ear Off
TOTAL COST OF PROJECT: $
5go
Overlay
DISCLAIMER
The permitted verifies, acknuwlcducs and agrees by their signature that: 1) If this pr.i mil: is I'or rur,strucliun ur on a dwelling, the dwelling Is/will
he served by putuble 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 rhe City or
Spokane Valley Develuprnent cone. Referenced codes are available for review at the City of Spokane Valley Pei mit Center. 5) The City of
Spokane Valley permit Is not a permit or approval fur any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to be subrniLcd and subsequently approved before this application can be processed,
Sig natu r Date:
/a - 7 /3
Updated 1-11.11
http://www...pokancvcllley.ury/tilestorage/124/938/210/948/1496/Reroof Permit_1-1.1-1.1.doc
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