2014, 09-08 Permit App: BLD-2014-2129 Tear Off, Reroof Project # � LlJ A —2�_'7
Community Development Department
Permit Center (stRf J E D
Spokane 11703 a t Sprague Avenue, Suite B-3 Spokane Valley,WA 99206 PERMIT NUMB [iej....)
Tel: (509) 688-0036 SEP 0 8 2014
Valley Fax: (509) 688-0037 PERMIT FEE:
oermitcenter@sookanevallev.orq
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REROOF CONSTRUCTION PERMIT APP1 ICA1ON REV. #
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COMMERCIAL RESIDENTIAL •
SITE ADDRESS:
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: •
BUILDING OWNER NAME: . • •
NAME: L„,(2.(k, 1 ,V> vses.,SC
ADDRESS: 11"l S.Lv Co 4'1 •
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CITY: SQ U'r�-� �
STATE: S 6 ZIP: 1 ] 2
PHONE: S Ucj — `j c/i c( '7 J FAX: CELL: •
CONTACT NAME: C 1A f,S qo,, ,),.e_;,3c,---•
PHONE: S 0 S— `i5 —01 ?c FAX: CELL: •
CONTRACTOR NAME:
' MAILING ADDRESS: .
. CITY: STATE: • .ZIP:.
PHONE: FAX: • CELL: . •
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
tear Off r ! Overlay
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,2TOTAL COST OF PROJECT: $ Soo ,
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 '' _._-- � --
--- Date: Cl'__`n -- (Lf
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc