2013, 05-14 Permit App: BLD-2013-0868 Reroof g� 11/1111b11 bb:14 y11yb5( Wbtbif uurtivu rHaa Ui,
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Permit Center OZA—e0/1,_680g
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Val11 703 ESprague Ave, Suite B-3 PERMIT NUMB R.:
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Spokane Valley. WA 99206 C�..✓ ��
ley° (509)688-0036 FAX: (509)688-0037 �..✓ PERMIT }'F.J✓: 8725
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wN .sizokanevallev.org
Coidmunity Development
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R roof Construction 11 Commercial
Pe it Application '� X Residential
siTFI A.DDR.ESs: / :74.3 £ ,'
AsS1.SSORS PARCEL NO:
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l3uildin2 Owner: • Contractors
_57— po;44 1 ,8r.,
Nam4
l Name: E:
IAddrilAddress: - d -ION , y/ 2,51 _
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c:1,: I State: Zip: City: 56t
1"vt``– (jt Stats,oe 943)47
Phoni: Pax: Phone:
I Contract Exp T)alP'
Cc►nt ct Person i --, _Ki 4063�� p Vii!7h ?
City 13usines� Lie.No:
N;;src
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l),scr be. the scope of work i detail:
Tear off I Overlay
Nares P [lit/if
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Cost iof- project: S a2 i ors,cis- ".
'The pt ;rniteo verifies, acknowledges and agrees by their signature that: 1) If this permit is for const uction of or on
dw011in�. the dwelling is/will be served by potable water. 2) Ownership of thus City of Spokane Valley Permit inure to the
property owner 3) The signatory is the property owner or has permission to represent the prop rty owner in thi:
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code
Re`eretced codes are available for review at the City of Spokane Valley Permit Center. 5) This City o Spokane Valle
Pcrm t lis not a permit or approval for any violation of federal, state or lociaI laws, codes or ordinan es. 6) Plans of
:adaf :oral information may be required to be submitted, and subsequently approved before this a plication can be
processed,
Owner jhip of resulting development rights granted by any issued permit inure to the property owner.
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SiFatui-c Date
Methof$i of Payment:
Cah ❑ Check 'Y'e Mastercard ❑ VISA
Bankc4rd #:,I_,. REDACTED _ _ Expires: REDACTED VIN#- RE ACTtU
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Authorized Signature:
This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
• and the original document destroyed pursuant to SOS DAN
•
• Effective Octobc G52014-030.
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P:\Cnmmunie' t)cvciopment\Form$\Building fc