2013, 07-08 Permit App: BLD-2013-1331 Tear Off, Reroof31ci —1 3 —133
Community Development Department
U� Permit Center (Staff Use Only)
SPDne Spoka e11703 aValley gue WA 99206e, Suite B-3 PERMIT NUMBER:
Tel: (509) 688-0036 V PERMn FEE: termit09)688-003] '
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REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL RESIDENTIAL
SITE ADDRESS: I I I (to 1. ID -M hp 12 6TFOY-(-Vie 110.1�9T'
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
l*Tear Off71 22r7 111 ElOverlay
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TOTAL COST OF PR03ECT: �� "l "17>
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) If MIs permit Is for construction or on a dwelling, the dwelling Is/will
be served by potable water. 2) Ownership of MIs 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 Mis transaction. a) All construction is to be done In full compliance win the City of
Spokane Valley Development code. Referenced codes are avallable 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 MIS application can be processed.
ci,nin.t.1 inl INA n Date: 1�
Method of payment: *ash ❑ Check ❑ Visa ❑ Mastercard
Effective October 28, 2007 Page 1 of 1
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Reroof Construction Permit App
10.28.07.doc