2013, 08-15 Permit App: BLD-2013-1618 ReroofSann,,an
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REROOF 1
Community Development Department
Permlt Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tec (509) 588-9W6 - 720 -5.z YO
Fax: (509)686-0037
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(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
APPLICATION
8M COMMERCIAL RESIDENTIAL
SITE ADDRESS Gni Lr, E ti �/)
ASSESSORS PARCEL NO.: 1� LEGAL DESCRIPTION:
BUILDING
OWNER NAME' (�n
iCa
NAME' 'b"
(A 4t h/or& —
ADDRESS:
CITY: �'DY-�r /l / t UC arnrE: tir
PHONE:"L / /� 1 FAX: CELL:
CONTACT NAME'
PHONE: F": CELL:
CONTRACTOIIRNAJME:
MAILING
ADDRESS: _Z
CITY �%L/C`2 LC� V(�("�`1 r�Z STATE: `A/ ZIP:. %/L
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE T"4 SPb-pF WORK IN DETAIL AND INDICATE USE:
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TOTAL COST OF PROJECT:
DISCLAIMER
Thaparonflinted veriFles, acknowledges and agrees by thelr signature that: 1) if this permit is for construction or on a dwelllog, 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 rmit or approy r any viol Von of federzl, state or local laws, codes or ordinances. 6) Plans or additlonal
Information may be required t submitted apE s�obsequentl�approved before this application can be processed. A.
Date:
http://www.spokanevalley.org/fiestorage/124/938/210/948/1496/RerooF_Permilt_1-11-11.doc