2012, 08-09 Permit App: BLD-2012-1278 ReroofCommunity Development Department —(g
Permit Center (Staff Use Only)
S~' °1 °t 11703 East Sprague Avenue, Suite B-3
pokane Spokane Valley, WA 99206 PERMIT NUMBER:
jUalley Tel (509)688-0036
Tel: (509) 688-0037 PERMIT FEE:
[)e,m,tcenter@spokane,alley.org
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL .W RESIDENTIAL
SITE ADDRESS: &7 2e. E _ e* — _
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: _
BUILDING OWNER NAME:
NAME: T M L 00SICIL
QTY: S KANA t).A 0"64 STATE: L -3A ZIP: 9
PHONE: 1� FAX: CELL:
CONTACT NAME:
PHONE:
CONTRACTOR NAME:
MAILING ADDRESS: MBCA PeAk C:.ONS"i vL}lw� LLL
CITY: ��lilcANr STATE: ZIP: 9;,)144
PHONE: �u5 Rc_R-y.ts� FAX: CELL:
CONTRACTOR LICENSE NO.: M i (-A PPL 9 rzaa P EXPIRES: .2o13 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
12[QsoF iii()kal+ SL.:,ura I2
g Tear Off
TOTAL COST OF PROJECT: $ l!i 3 /00 . eY
® Overlay
The permitted verifies, acknowledges and agrees by their signature that: I) if this permit Is for coni uction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this Oty of Spokane Valley permit Inure to the property owner. 3) The signatory Is Ne 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 rot a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be redpAed to be submitted and subsequently approved before this application can be processed.
Date: 9- 9- /z
1 Page
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Re=LPermit_1-11-11.dm