2012, 08-30 Permit App: BLD-2012-1460 Re-Roof I
,,,..4 Community Development Department
Permit Center (Staff Use Only)
• SCITY Wu -pokane m 1 Spokane11703 Valey, WA 99206st Sprague Avenue, SUlte B 3 PERMIT NUMBER: 1�� �7— / `4C
Tel: (509) 688-0036 J-
Valley Fax: (509) 688-0037 PERMIT FEE: `7.�� 7/f
oermitcenterPspokanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL )kIESIDENTIAL
SITE ADDRESS: 411
""?acci E . < 0
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER (NAME:
NAME: W1c., to \FY-v -
ADDRESS: -7 2C)) C. t.o-vr l�'`
Cm: (4-.-c1 rr-R ��'(z-G' 4)— VGL STATE: j ZIP: l re 2-1 ?
PHONE: Cc. C1) ca et — 't 4 D ( FAX: CELL:
6
CONTACT NAME: ONA(Cp Fe'(-wV
PHONE: FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS: Ccp_ar
CITY: STATE: ZIP:
PHONE: FAX: CELL: •
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DE CRI/BB�E THEnnSCOPE OF WORK IN DETAIL AND INDICATE USE:
re -IS[9e�`C- 6-c--r 0, (-7 6
*Tear Off 111 Overlay
(((TOTAL COST OF PROJECT: $ _ (1OO
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 not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed. /
Signature /�/ �, i , Date: rel�, /r' Z
•
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc