2012, 02-06 Permit App: 12000265 Tear Off, Reroof 02/06/2012 12: 02 GRANITE ENTERPRISES (FAX) 2086873907 P. 001/002
Community Development Department
Permit Center (Staff Use Only)
SCI rYo/'� 11703 East Sprague Avenue, Suite B-3 l�
Vile Spokane Valley, WA 99206 PERMIT NUMBER: +. (OS-
Tel:
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Tel (509) 688-0036
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Valle Fax (509) 688-0037 PERMIT FEE: tir;
REROOF CONSTRUCTION PERMIT APPLICATION
0 COMMERCIAL r.T:; RESIDENTIAL
SITE ADDRESS: /O'a) r, /S fh 11-Ven U.c_.
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: 1" i ke, awl 1R otrn 5i4'k
ADDRESS: l o 61.1 I E, j Qp-fh 4-Venwb
CITY: / 500k--0,11-e- Vat tX STATE: W f - ZIP:
PHONE: (5c ) —q)e) FAX: CELL:
CONTACT NAME: Pin k_ how. SfYl.i-}
PHONE: FAX: CELL:
CONTRACTOR NAME: &r&Ln(fe Evit-u p , Jy ,
MAILING ADDRESS: PO Box 5o
CITY: /-a�fain STATE: Lb ZIP: 83858
PHONE: (:0,3) t!j 11 / - 477 FAX: � b2)Iv$7- 3t 7 CELL: ',r
CONTRACTOR\ LICENSE No.: GRAN)EJO1 TA EXPIRES: 3)2+J2bI2 CITY BUSINESS LICENSE NO.: (pp)553L/-73q-1-2_
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE.USE:
_ ear o ' i_ •• n�`/' Jo �zefinj . 70)y a h4 W shill new Iamn inR�. s uszg/
) , Ice. Loa shceld, 3o pelf ri�5evcr-/ th-.
Tear Off 0 Overlay
TOTAL COST OF PROJECT: $ PI 300.00
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 maybe required to be submitted and subsequently approved before this application can be processed.
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Signature �reL e Date: Feb O�/moo/Z
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Updated
ve dTime ime Page 1 of 1
Feb. 6. w2U�2 k1 2: 52 PM.cNo. 6326rage/124/938/210/948/1496/Reroof Permit_1-11-11.doc
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