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2015, 03-04 Permit App: BLD-2015-0382 Tear Off, Reroof Community Dedeloprnent Department Permit Center (Staff Use Only) sou11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 PERMIT NUMBER: le3 Tel: (509) 688-0036 4 °Val " Fax: (509) 688-0037 PERMIT FEE: permitcenter©sooka nevallev.orq REROOF CONSTRUCTION PERMIT APPLICATION 0 COMMERCIAL RESIDENT SITE ADDRESS: Pro.e = % _' A • ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: ' .4 r4 BUILDING OWNER NAME: RECEIVED L- I IE',= 0 4 !U15 NAME: \ ' ADDRESS: J`^� E. I t& C SV t ' 1{ r/� ) CITY: ,5rk,kile �/011 le V� STATE: CJ�-1 SS UB U •. -,f`,, I 'tj J -l■..1— ' rim PHONE: FAX: CELL: aCt --' -_ CONTACT NAME: PHONE: FAX: CELL: CONTRACTOR NAME: ` $\-• c;,,,AJ6;o(-) Secv;ce-) , LLC MAILING ADDRESS: I t 1 Li L . �2r .4.a;ckQ,Acc C-1Lie _ CITY: ►rkpo✓\" STATE: GJ • ZIP: ® PHONE: SCA - ).,I 6 -O S SX FAX: CELL: coq- ,p,i6"®iSg CONTRACTOR LICENSE No.: 6-01~'t112 (.4"0Q C EXPIRES: 10//a7/t 6 CITY BUSINESS LICENSE NO.: DE CRIB 55HE SCOPE OF WORK IN DETAIL AND INDICATE USE: !G!`.( ott ex SK.,\51eS `1 inl--c \ y a J 'g 51eve_e4\vi0 75,Tear Off .. Overlay TOTAL COST OF PROJECT: $ 103_ 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 411111 Date: -4 1- 1� Updated 1-11-11 Page 1 of 1 http://www.spokaneval ley.org/filestorage/124/938/210/948/1496/2743/Reroof.doc