2013, 02-08 Permit App: BLD-2013-0213 Reroof 7"'< Community Development Department
ar. Permit Center (Staff Use Only)
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Spokane -- 11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206 PERMIT NUMBER:
Valley Te (509) 688-0036 a /0/ 75
Fax: (509) 688-0037 PERMIT FEE:
permitcenter(aspoka nevallev.orq
REROOF CONSTRUCTION ERMIT APPLICATION
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COMMERCIAL RESIDENTIAL
SITE ADDRESS: /1 / t the ----__
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ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: 1-)C. a 11 bid 50 in
ADDRESS: JOS G15 W V i'5 ,/�
CITY: [ 4v1.Q Va ile STATE: �4 1 ZIP:
S ,/
PHONE: Q 2( (j g 0./S FAX: CELL:
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CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: I
MAILING ADDRESS: 1 t '
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK,IN DETAIL AND INDICATE USE:
15 seucc'es f rp — fe-S 'de►1LE._
Tear Off od Overlay
TOTAL COST OF PROJECT: $ ,3Z0 (2 ��
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 repr- ent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development ose. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is no. . p-rmit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be requires o se submitted and subsequently a rove before this application can be processed.
Signature ( # Date: _
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Updated 1-11-11 a I i r r 1 I f 1
http://www.spokanevalley.org/filestorage/124/938/210/94$/ 496j�teroof_Permit_1-11-11.doc ��