2013, 07-10 Permit App: BLD-2013-1350 Tear Off, Reroof Community Development Department
Permit Center (Staff Use Only)
SCI1Yot 11703 East Sprague Avenue, Suite B-3
pokane Spokane Valley, WA 99206 PERMIT NUMBER:
Valley Tel: (509) 688-0036 Cl �.'7
Fax: (509) 688-0037 PERMIT FEE:
perm itcenter@spoka neva l ley.orq
REROOF CONSTRUCTION PERMIT APPLICATION
El COMMERCIAL RESIDENTIAL
SITE ADDRESS:
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: C%4 ig `/-74 a,,,i
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: /
•
MAILING ADDRESS:
CITY: 49/ I 02/t A A STATE: /(,),.Q ZIP: 919Q6-2
7
PHONE: 9c2 y-- e 2 7 3 FAX: CELL: 993- 5/C 7 7
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
IS -ar Off El Overlay
TOTAL—C•ST OF PROJECT: $ S
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 f-deral, state or local laws, codes or ordinances. 6) Plans or additional
information may e2tluired be submitted and subsequently appro -d .efore this application can be processed.
P'
Signature cc. / / /i Date: 7_
Updated 1-11-11 Page 1 of 1
http://www.spoka neva Iley.org/filestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc