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2012, 06-14 Permit App: BLD-2012-0887 Reroof Community Development Department CITY(7F ~--- Permit Center (Staff Use Only) Spokane 11703 East Sprague Avenue, Suite B-3 Spokane Valley,WA 99206 PERMIT NUMBER: ' 7i11cy® Tel: (509) 688-0036 do ® Fax: (509) 688-0037 PERMIT FEE: permitcenter@ sookanevaIlev.orq (J\l- 2,C)1.? — g� REROOF CONSTRUCTION PERMIT APPLICATION 0 COMMERCIAL --RESIDENTIAL • SITE ADDRESS: if 20 ? • A11 ASSESSORS PARCEL NO.: LEGAL DESCRIPTIO A , BUILDING OWNER NAME: '3'ccR " d51—c, 111Millink . NAME: g c/ Fr:357Zti `MI- ADDRESS: . ` ,777 _=1 CITY: „dr C_ 44/AD L_ STATE: L‘..) 1111111MEMM PHONE: el C\— 9/d L Ili 4111162111M111111111/ CONTACT NAME: roc. /, PHONE: 2©g - 2_2__- cmc lli _ CONTRACTOR NA E: )c-4,,_ 7{c - i2E4n, AJMINIIIIIIMIKIr . MAILING ADDRESS: U' �� ® `® it, CITY: P41777(9eCe/1111=1 STATE: . -770 In .ZIP: • ` "J PHONE: 208-- Zc,Z (3©Y'g FAX: _ e! 5"an i. . CONTRACTOR LICENSE No.: "6-47741619/3 -S EXPIRES:/Z'20(Z. CITY BU INESS LI• SE NO.: DESCRIBE THE . OPE e F WORKpI►r DETAI . ND INDICATE USE: i . i_t I Cx,, IT . l ,h i -R' Tear Off fl Overlay TOTAL COST OF PROJECT: Z5-0 l DISCLAIMER ti, The permitted verifies, cknowledges and a• ees by their signature that: 1 - - •-rmit is for construction or on a dwelling,the dwelling is/will be served by potable wa r. 2)Ownership . this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property owner or has permission to epresent the pro.'erty owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Developmen code. Referen,ed codes are available for review at the City of Spokane Valley Permit Center. 5). The City of Spokane Valley permit is not . rmito pr,val for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be required to .- submitte a d subsequently approved before this application can be processed. Signature ���. ��_ Date: 6 -/ -_ &: &L7YlLki Oil 6 i / mori Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc