2014, 09-25 Permit App: BLD-2014-2293 Re-Roof Community DPvelopnii�nt Department
Permit Center (Staff Use Only)
SCITYokane 11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206 PERMIT NUMBER:
Valley
Tel: (509) 6 -003 tecta—s�yo
Fax: (509) 688 0037 PERMIT FEE:
rermitcenter@casookaneval lev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL VQ RESIDENTIAL
SITE ADDRESS: �C.t�P -oi 11-'p22ci 3
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: fvf (2C-,ait_
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NAME: IC e__ /20,-n Lt,-e_
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ADDRESS: J /0g s ' See t-ek !(�
CITY: ,3�-cch ✓"e— STATE: ZIP: / i 3'
PHONE: FAX: CELL: _Cb ,;218' 7 708'
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK I DET IL AND INDICATE USE:
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Tear Off ❑ Overlay
TOTAL COST OF PROJECT: $ 3509
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: 9/2_5--/
Updated 1-11-11 Page 1 of 1
http://www.spokaneva Iley.org/fi lestorage/124/938/210/948/1496/2743/Reroof.doc