2014, 05-27 Permit App: BLD-2014-1202 ReroofSep.13 10:.46AM
$ kth e
Vale
Project # I PD 2 -
RECEIVED
Community DeYelUnefR biaarement
Permit Center
�geQIU
117,03 sti.SL'VJA'99 gEfiAt
Spo ane vel y, 2
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••SL q Ea9):B9-o.37REV. #
No, 4815 P. 3'
(Staff Use Only)
ERMIT NUMBER:
ERMIT FEE!
REROOF CONSTRUCT/0
MIT APPLICATION
1 j C MMERCIAL
•--91-TE::ADDRESS;
RESIDENTIAL
'ASSESSORS PARCEL NO.:
:HUIWING OWNER NAME;
LEGAL D S r RIPTIONr,
p Yab
a - f)•"6 ictA,1,52:
PHO.i.:•NE: . 10361 4.9
a
Vt1,�?# .)h_
P
-Ci NIACT NAME;
ZIP, 699°2/ 07..:
CELL:
e,FibNEf ,t ,
C3. NTOA'CTOR NAME:
iIts
L; .:
EtAt R,G,ADDRES
ar.,.
tJ"7RSORI.ICENSE
DX.SeFtIt3E THE SCOPE OF WORK IN DETAIL AND INDICATE USE;
•
Fax:
CELLI
�.J.j�,�y, �) IPt, ? 9a o /a
NESS /7a/O/
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ftx`'C1JST DF PROJECT, 1� q l / `�, v Overlay Copy • '
:fl .
,�}TstatMgR .
TAC perrriltted verlfles, acknowledge; and agrees by their signature thou 1) If this permit Is for construction or on a dwelling, the dwelling fs/w1II
S&served by potable Water, 2) Ownership aF this City of Spokane Valley permit Inns to the ptoperty owner. 3) The signatory is the property
o*ner orris; permission to represent the property owpor '1 thIS transaction. 4) All construction Is to be done In full compllanee With the CIN of
C'�'dkanp; .alley pevelopment code. Referenced codas are available for revloW at the City of Spokane Vasey Permit Center, 5) The City or
$pok'Cne•yafley permit Is nob a permit or approval for any violation or federal, state or local laws, codas or ordinances. 6) Plana or additional-•
timaft8n may be aired to be s bmltted ofd svb a anti roved beFara this application can be processed.
r t t .atIo :.aye :' n• 1. Y P PP
Si91fi4it1 •a : �t it �n Date: ' . 7
iNiE'lli gNpayment:
{Jalilcc'ard a;
'hiiHikd"SI9natorr
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1.
Ts Chgck.
sa JD Mastercard
VIN#:
tch, Octobesr 29, 2007
;,,:9l-\CoKimunity Dcveiopmenv\02 Administration \03 Forms • Official VI
t• 10.28.07,doc
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,REDAGTEP
This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
and the original document destroyed pursuant to SOS DAN
652014-030.