2014, 04-29 Permit App: BLD-2014-0909 Tear Off, Reroof Community Development Department
"► �Typr Permit Center (Staff Use Only)
Spokane 11703 East Sprague Avenue, Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:
Valley Tel: (509) 688-0036
Fax: (509) 688-0037 PERMIT FEE:
permitcenter@spokanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
111 COMMERCIAL 0 RESIDENTIAL •
SITE ADDRESS:
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING('OWNER NAME: /� .
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NAME: 1-e 1 ttv\c (1C mG+V \ n /�
ADDRESS: 1� 6.-2, 3 I j� 1-6\ ' -Ue_.- /
CITY: S t rJ\ (,1,1( UG`\( e j( STATE: A- ZIp: q� 20 1 '
PHONE: Cs ' ) 6 o 97 6 7 FAX: CELL:•CONTACT NAME:
PHONE: FAX CELL:
CONTRACTOR NAME: vi/1/ R.00*/
. MAILING ADDRESS: • / tt//. piiic SI.. �/
CITY: ...54-aet po r6'1.� STATE: .�IT . .ZIP:. gpb
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PHONE: L FAX: /- •
�/CELL:
�CONTRACTOR LICENSE No.: �k,,q 1(��\t3?,JCr FIRES: S/ S CITY BUSINESS LICENSE NO.: O 3 S S .
DESCRIBE THE,S,COPE OF WORK IN D TAIL AND INDICATE USE:
�-ea_l2 - o 20ot ote-e.- - 6()\'
Tear Off 0 Overlay
TOTAL COST OF PROJECT: $ (/ 5-70
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 permi '- . - -emit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may b- equired to b. submitted and subsequently approved before this application can be processed.
Signature Date: 0 9/7
Project # i2041' 6°
- RECEIVED 61"-/
APR 2 9 2014
CSV PERMIT CENTER
Updated 1-11-11 SUB # { REV. E6ge 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1495 Reroo 11 rinc _