2014, 09-15 Permit App: BLD-2014-2186 Reroof Community Development Department
Permit Center (Staff Use Only)
SCITYpokane 11703 East Sprague Avenue, Suite B-3
�Te Spokane Valley,WA 99206 PERMIT NUMBER:
♦�l��e' Tel: (509)fi `7d
S�-8036 0-5.2'10
Fax: (509) 688-0037 PERMIT FEE:
perm itcenter@spoka neva I lev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
0 COMMERCIAL RESIDENTIAL
SITE ADDRESS: E T w �----
ASSESSORS PARCEL NO.: LEGAL DESCRIPTI. 4: if
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f .,,c , r,:__g�I /isy —/S �
BUILDING OWNER NAME: `kp r� i-,o i1 �c�fv -
NAME: 0 t)Il Pc, /GO `
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ADDRESS: 2 / i'1 q L i 2014
CITY: 1' ij LicAlley STATE: P1/AL . C(-: r ;-F1 /IT' CENTER
PHONE: V 7 FAX: ' 5 i_I`- .!;CELL: _. i
CONTACT NAME: _.,..,
PHONE: FAX: CELL:
CONTRACTOR NAME: 5 %l�1 11. '. 17 (�)
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MAILING ADDRESS: 9/576,9/576, 4,
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CITY: 5 p o /__ r f,3 eu4,/1. STATE: /4/4—" ZIP: ?C��j /
PHONE: 9:72. `.,7- � 3, FAX: CELL: 6 t/
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESC- BET. E SCOPE OF WORK IN DETA AND INDICATE USE:
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❑ Tear Off aOverlay
TOTAL COST OF PROJECT: $ L4/("0' ad
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 of a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be requi e to be submitted and subsequent approved before this application can be processed.
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Signature ^�/ Date: /. ---1 o,v04
Updated 1-11-11 Page 1 of 1
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