2015, 04-16 Permit App: BLD-2015-0844 ReroofSfio'lane
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@ sookanevalley.org
Project gpcis—c
(Staff Use Only)
PERMIT NUMBER: -S 15
SUB REV #
REROOF CONSTRUCTION PERMIrnnr
-APPI A*lON—
❑ COMMERCIAL
SITE ADDRESS:
E I-1 ESIDENTIAL
ASSESSORS PARCEL NO.: LEGAL DE RIPTION:
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BUILDING OWNER NAME: 10 kC1 - ,pkev-ain L joeL Zvi_
NAME: ( kt-11. e5i'Dit) bier a v �J pa
ADDRESS: `S 11 �V�r�1�` (t�l`( \UES
CITY: Spo V b I J
PHONE: 5-0-32.1t) g j I 1
CONTACT NAME: J c d,L a i t
PHONE:
STATE:
Fax:
FAX:
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ZIP: GM, pL- L
CELL: 0!–clog- / t„qs
57)1.-11-62(e0-5
CELL:
CONTRACTOR NAME: 5R 61-1 e
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:
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TOTAL COST OF PROJECT: $ 3 5 Of)
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Overlay
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 ce. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit Is no /permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be requlr-: o be submitted and A quently approved before this application can be processed.
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Signature
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Date: -)(p-L5
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/ 124/938/210/948/ 1496/2743/Reroof.doc