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2011, 06-07 Permit App: 11001615 Tear Off Roofing Community Development Department • Permit Center (Staff Use Only) . 11703 East Sprague Avenue, Suite B-3 ISjökane / JSpokane Valley, WA 99206 PERMIT NUMBER:/ Valley Tel: (509) 688-0036 �J Fax: (509) 688-0037 PERMIT FEE: ©I� f J 41• - permitcenter@spokanevallev.orq REROOF CONSTRUCTION PERMIT APPLICATION 0' COMMERCIAL [)Zt RESIDENTIAL SITE ADDRESS: Q. 311-7 ()Di L6i4(2- ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: ADDRESS: 3211 N` WILBNe... CITY: `?0ANIS JAL.L y STATE: (,,}A. ZIP: PHONE: FAX: CELL: CONTACT NAME: tAtel, peg.lVSR" PHONE: (.: '* FAX: CELL: (99q)Ciel Ciel I- rj I¢jC� CONTRACTOR NAME: A4e .e 0,66. 2opf(/JI(� l /- MAILING ADDRESS: .2les 1 � Mui-LAi L 3. CITY: L 1 v '' L_ (t�� STATE: la • ZIP: PHONE: k 06e FAX: CELL: • CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: lYt Tear Off 111 Overlay TOTAL COST OF PROJECT: $ 3SOQ, W 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 permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be required to be submitted and subsequently approved before this application can be processed. Signature Date: Orla-VMA-I b(7I I Updated 1-11-11 Page 1 of 1 http://www.spokaneva lley.org/fi lesto rage/124/938/210/948/1496/Reroof_Perm it_1-11-11.doc