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2013, 09-25 Permit App: BLD-2013-1941 Tear Off, Reroof Addition Community Development Department Permit Center (Staff Use Only) SCITYQN 11703 East Sprague Avenue, Suite B-3 pokane Spokane Valley, WA 99206 PERMIT NUMBER: Valley. Tel: (509) 688-0036 Fax: (509) 688-0037 PERMIT FEE: permitcenter@ spokanevallev.orq REROOF CONSTRUCTION PERMIT APPLICATION 0 COMMERCIAL7)7 ►: RESIDENTIAL)1I SITE ADDRESS: 6e©, f// �'� �/'"�' ,1.49/44vie 1fre ASSESSORS PARCEL NO.: LEGA 'ESCRIPTION: BUILDING OWNER/NAME: NAME: >`,'(!4 L ADDRESS: . y /3 .P/ S. Ar-052‘.4) -le CITY: 5/049A STATE: /4. 71--- ZIP: P92 PHONE: S • X32 /���J FAX: CELL: Z� 9— cJ 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: 0 Tear Off 0 Overlay TOTAL COST OF PROJECT: $ 0P.0 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 subseque ly approved before this application can be processed. Signature � Date: � SP 7/ 9 ice 1 �� (J ZO 13 -- V (( E E VES,-T' SEP 25 2013 _._ • ` SV PERMIT CENTER sum " l�`_\�Yi, L....F Updated 1-11-11 http://www.spoka neva)ley.org/fi lestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc