2015, 05-05 Permit App: BLD-2015-1025 Reroofspokan' ems`
jValley•
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@ spokanevallev.orq
CSVirr'','i C
REROOF CONSTRUCTION PERMIT APPCT ATION/.
0l COMMERCIAL
SITE ADDRESS: �j/� 1f iL S-
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
RESIDENTIAL
BUILDING OWNER NAME:
NAME:
ADDRESS:
CITY:
PHONE:
STATE: {jt)
FAX: CELL:
ZIP:
CONTACT NAME: ()_)\\. 1u A-ev –4i) '
PHONE: – .2 – �) 7 co FAX: CELL:
CONTRACTOR NAME: CA\u-at.- ` 'er5v.r\. 0c9St
MAILING ADDRESS: 66 /• (4,j0(/J 7
CITY: 5( / STATE: ��1 ZIP: 99 -T? --C
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.: Ch,}61..-W YLI—EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
1 Tear--Aff
TOTAL COST OF PROJECT: $
Overlay
DISCLAIMER
The permitted verifles, 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 repres erty owner In this transaction. 4) All construction Is to be done in full compliance with the City of
Spokane Valley Develop ode. Refere ed codes a - avai, ble for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley per,. is not a permit • .ppro y viol- on of federal, state or local laws, codes or ordinances. 6) Plans or additional
information m .e requi -d • . u •�—�bsequen pproved before this application can be processed.
Updated 1-11-11
http://www.spokanevalley.org/filestorage/124/938/210/948/ 1496/Reroof_Permit_1-11-11.doc
Page 1 of 1
R (Fff!U0/'QI3
PERMIT NUMBER:\
�
PERMITTEE: AYU
CSVirr'','i C
REROOF CONSTRUCTION PERMIT APPCT ATION/.
0l COMMERCIAL
SITE ADDRESS: �j/� 1f iL S-
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
RESIDENTIAL
BUILDING OWNER NAME:
NAME:
ADDRESS:
CITY:
PHONE:
STATE: {jt)
FAX: CELL:
ZIP:
CONTACT NAME: ()_)\\. 1u A-ev –4i) '
PHONE: – .2 – �) 7 co FAX: CELL:
CONTRACTOR NAME: CA\u-at.- ` 'er5v.r\. 0c9St
MAILING ADDRESS: 66 /• (4,j0(/J 7
CITY: 5( / STATE: ��1 ZIP: 99 -T? --C
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.: Ch,}61..-W YLI—EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
1 Tear--Aff
TOTAL COST OF PROJECT: $
Overlay
DISCLAIMER
The permitted verifles, 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 repres erty owner In this transaction. 4) All construction Is to be done in full compliance with the City of
Spokane Valley Develop ode. Refere ed codes a - avai, ble for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley per,. is not a permit • .ppro y viol- on of federal, state or local laws, codes or ordinances. 6) Plans or additional
information m .e requi -d • . u •�—�bsequen pproved before this application can be processed.
Updated 1-11-11
http://www.spokanevalley.org/filestorage/124/938/210/948/ 1496/Reroof_Permit_1-11-11.doc
Page 1 of 1