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2012, 03-12 Permit App: BLD-2012-0132 Reroof „ \ Community Development Department Permit Center `},. ”" ctTYO�` �' - 11703 East Sprague Avenue, Suite B-3 (Staff Use Only) �.Jp ane Spokane Valley,WA 99206 PERMIT NUMBER: Valley Tel: (509) 688-0036 it 1 Fax: (509) 688-0037 PERMIT FEE: perm itcenter©sooka neva Iley.o rd (3 -0— UVZ-- 0 13a REROOF CONSTRUCTION PERMIT APPLICATION COMMERCIAL XRESIDENTIAL . SITE ADDRESS: I,//L/ /,---- ASSESSORS 3ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: .,\)e....Y-.e.- - Ai c> 'i, • . NAME: \ppS) 0 N.1.1/‘ t4 ADDRESS: j \ 1�"\ \,© tT)'j � . • CITY: S;i>O , NJ(46A STATE: V�.///L ZIP: 92/ 7 PHONE: �i j i' 1 FAX: CELL: - _ 6-- CONTACT NAME: PHONE: . . FAX: . CELL: • • CONTRACTOR NAME: • MAILING ADDRESS: . CITY: STATE ZIP: • PHONE: • . FAX: - CELL: • • CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: • DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: . Tear Off f �,� Overlay • TOTAL COST OF PROJECT: $ f 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 -----7/-7,... .....,-. Date: C 3 /2 Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc