2014, 11-21 Permit App: BLD-2014-2825 Reroof t
Community Development Department _
Permit Center ilfia Crib
11703 East Sprague Avenue, Suite B-3
*Oliall°'°:444 Spokane Valley, WA 99206 PERMIT 1} .y BoR'iy a{
lley Tel: (509) 688-0036
Fax: (509) 688-0037 PERMIT FEE:
4000111;Vat
permitcenter@spokanevallev.orq I 1% r* 71 -,^:ram
REROOF CONSTRUCTION PERMIT- TIc N' "
0 COMMERCIAL WRESIDENTIAL
SITE ADDRESS: 9,70 5 /j . JC�tl Wu r/A I IJk
ASSESSORS PARCEL NO.: LE AL DESCRIPTION:
BUILDING OWNER NAME:
NAME: -Pcit,yl/t C.__VA Mot Y' I Q l/Vf
ADDRESS: f. ! L,T A. ktie (1�k�it vC( 1�
CITY: S pdka A , //fly STATE: /4f/4/ ZIP: 9l.7GdCJ
PHONE: \-57 – /3 O/ FAX: CELL:
CONTACT NAME: pjy/IA Aa
PHONE: FAX: CELL:
CONTRACTOR NAME: Sr A a 4 . P.,,m4 iy, `d-
MAILING ADDRESS: - 1 ,i4,--5,,,,,,v, 4,,
•
CITY: S:'f) gC V t C STATE: �ll ZIP: ?9,2416
PHONE: 902
-7 —`3 03 FAX: CELL: y/�- f9'3
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off ,IR Overlay
TOTAL COST OF PROJECT: $ ( 72 CO , G
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 per 't 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 eduired to be submitted and subs quently ap roved before this application can be processed.
Signature (// A ci , Date:
Updated 1-11-11 Page 1 of 1
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