2014, 04-28 Permit App: BLD-2014-0899 Tear Off, Reroof •
Community Development Department
Permit Center (Staff Use Only)
SiYO1�ane 11703 East Sprague:a}fel~.ue,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:
Valley Tel: (509)688-043-36,- -7. 0-51.2 YO
Fax: (509)688-0037 PERMIT FEE:, .
oermitcenterl sookanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL RESIDEI rWIct ,Up_174 tt4, o`5g.ci
SITE ADDRESS: RECEIVED f
ASSESSORS PARCEL NO.: 1 LEGAL DESCRIPTION: �1
BUILDING OWNER NAME: APR 2
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NAME: L. , ,„ A. 0 r TO l., „v (5' v f c li CSV PFRMIT CENTER
ADDRESS: 1 +r .11- - , r
CITY: If O e K,,, L STATE: C-- - .--.____
PHONE: FAX: CELL: •
CONTACT NAME: - •
PHONE: FAX: / CELL: • •
CONTRACTOR NAME: •
,—/� v o �i 1 •. .
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MAILING ADDRESS: . ! J 3 -• p A-4v ,[ / •
CITY: • P /9 Ill 4 f V ,. cf
STATE: 1 U ' ZIP:. a `�
PHONE: J'0 41 • 1lo — 7 b 7 V FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: .
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DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: .
ear Off + CIOverlay
TOTAL COST OF PROJECT: $ l 3/ v:., u
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/gdhas 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 rmit or approval for any violation of federal,state or local laws,codes or ordinances. 6) Plans or additional
information may be required , .e su.mitted and subsequently approved before this application can be processed.
Signature ,,. �Y
Date: 9 •) P i k
y
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Updated 1-11-11 - Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc