HomeMy WebLinkAbout2013, 05-20 Permit App: BLD-2013-0930 Tear Off, Reroof Community Development Department
Permit Center (Staff Use Only)
Sul'Oro
okEast SpragueW9206e, Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:
Valley. Tel: (509) 688-0036 PERMIT FEE: -7 3'%
Fax: itcen 688 00374101
0ermitcenter@-0037 evallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
El COMMERCIAL // RESIDENTIAL f a _53v
Cjoo 6 l; (/ GIP �� �4vC� Project # Mc( 3
SITE ADDRESS: � y
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: RECEIVED
BUILDING OWNER NAME: lC nvy &e,1,12eyMAY0 2013
NAME: g.o1/.7"
6K 1 CSV PERMITCENTER
ADDRESS: i/C). g (i //l6� y
/� � / ( STATE: SUB ZIP: I� U I
CITY: S/v _ (//GG�(��/ ._ I
PHONE: J0 ( W 7-30 7 FAX: CELL: 90-0 (6 7•
._
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: cO ri.42>,— •
. MAILING ADDRESS:
CITY: STATE: ZIP:.
PHONE:
FAX: CELL: '
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Te a. p'f?� Z Ia yev. q
Tear Off Iii Overlay
TOTAL COST OF PROJECT: $ ZeVe, as
DISCLAIMER
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 --=rmit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required t• .- submitted and su equen• approved before this application can be processed.
Signature / t - / Date: 6----2_,0 - 24, (3
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Updated 1-11-11Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc