2013, 08-08 Permit App: BLD-2013-1573 Tear Off, Reroof 11-13, 20/3— 1573
�, Community Development Department
Permit Center (Staff Use Only)
Siio1
�ane poke East Sprague Avenue, Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:
Valley. Tel: (509) 688-9836--- "7.0-s.2yo ,N ��I.16Fax: (509) 688-0037 PERMIT FEE: �C
oermitcenter sookanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
Er COMMERCIAL ] RESIDENTIAL .
SITE ADDRESS: 1l ' a) E (D
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: • .
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL: •
CONTACT NAME:
PHONE: F//AX: CELL:
CONTRACTOR NAME: }--C� �nr\ Ryh LLC '
MAILING ADDRESS: &SU,..)& C g...,LC t. A.,
• . . .
CITY: �p(�V STATE: W ZIP:�Cf Z(Z
PHONE: 4Vc 99c? 50G. FAX: 505 " : L j > CELL:
CONTRACTOR LICENSE NO.: ¶A eM mus ZSYY),XPIRES: /fl./2ci,y CITY BUSINESS LICENSE NO.:
D CRIBE THE scipIDE OF WORK AN DETAIL AND INDICATE USE:
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Tear Off ID Overlay
TOTAL COST OF PROJECT: $ 6--utp
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 ("j.... FLS-- Date: V/Mg
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc