2013, 08-21 Permit App: BLD-2013-1657 Reroofo,Neft
Spokane
jUalley°
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-9936— '720 -51.2 VO
Fax: (509) 688-0037
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REROOF CONSTRUCTION PERMIT APPLICATION
[r COMMERCIAL ) �=, RESIDENTIAL
SITE ADDRESS: /0/ 22_ vel
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ASSESSORS PARCEL NO.: LEGADESCPT
ION:
BUILDING OWNER NAME: cur
NAME:
ADDRESS:
10122 C. VI) 19fcA-6� .
CITY: 31CAA (f
PHONE:
STATE: \A.A.)
ZIP:
FAX: CELL:
CONTACT NAME:
PHONE:
CONTRACTOR NAME:
MAILING ADDRESS:
FAx:
CELL:
A S 0,11Q.
CITY:
PHONE:
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CONTRACTOR LICENSE No.: kV—\u F p_p L EXPIRES:
STATE:
CELL:
ZIP:. q q2/-
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CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
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Tear Off
TOTAL COST OF PROJECT: $
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ID Overlay
DISCLAIMER
The permitted verifles, 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 oval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may •e required to be submit d subsequently approved before this application can be processed.
Signature
Date:
2// /3
Updated 1-11-11 Page 1 of 1
http://www.spokanevailey.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc