2011, 06-17 Permit App: 11001785 ReroofCommunity Development Department
Permit Center (Staff Use Onlyl
CITY SpWane 11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206 PERMIT NUMBER: ! J
Valley Tel: (509) 688-0036 l 0j
�' Fax: (509) 688-0037 PERMIT FEE:
permitcenter(asookaneva Ilev.ora
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL _ RESIDENTIAL
SITE ADDRESS: �ZOD�-- 'j-:, - � (AV &., V
ASSESSORS PARCEL NO.:--}�j9?1 a Oily -'{LEGAL DESCRIPTION:
BUILDING OWNER NAME: i',n il/-�, f� a i\i
NAME:
ADDRESS: T/ 2 L—t rV i U VU
CITY' ` ►' ! i �(�flf qj 1 1,!p I I STATE: ZIP'
PHONE: ""i' ! 1 1�j 1 -mo l' 'i�T I ( FAX: CELL:
CONTACT NAME: �1i
PHONE: /l r rives c��r U�tiL' Y -t'—,- FAX: V-1 CELL:
CONTRACTOR NAME:MCVAY BROTHERS
MAILING ADDRESS: 11420 E. MONTGOMERY
CITY: SPOKANE STATE:WA ZIP:99206
PHONE:(509) 928-4686 (�i i�t �: N FAX:(509) 252-2996 CELL:NiA
CONTRACTOR LICENSE NO.:MCVAYBC346ME 4: 11� I EXPIRES:N/A CITY BUSINESS LICENSE
NO.: N/A
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off Overlay
TOTAL COST OF PROJECT: $
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 wate ) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission represent the property (oaW�'ner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Develop ent ?;de. /,Ref enced odreqenv vailable for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit not a permit or appro I folation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be re ired tp6a Tbm' ed a d suy approved before thsapp\ tion can be processed. '
Siqnature
Date:
Received JTime-'Jun. 11. 2011 .,1;5,1 PM N0.2004 Page IofI
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