2013, 02-28 Permit App: BLD-2013-0310 Reroof 130-2013-030
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11703 E Sprague Ave,Suite B-3
Spokane Valley,WA. 997.06 PERMIT PEE: # !L{3.75
rnoolFValley.° (509)688-0036 FAX:(509)688-0037
www_spokanevallev.ora
6
Community Development COPY
2/Reroof Construction ❑ C' mercial
Permit ApplicationResidential
SITE ADDRESS: 1 ` 5 D41 G `C--4 GC
-A 4
ASSESSORS PARC T..NO:
Building Owner: Contractor:
Name: `-r- Name: Teva. "liC:1e 4) f rye;gt 0&r 6C»
Address: as o l lig 19 Address: 9, v -ta e-1
Zip: //Q Cisj+: t, A`w -''�� 14- Zip:cC`at
City: 5 , v State:w U ` po
Phone: 61 •at 4191 ✓s Fax: _Phone: 1 o Fax: ty
Ci
y'�� Contractor Lie Noy�lI�! p q Exp1 tril /Data: 5-of
Contact Person _\Ds City Business Lic.No:
Name:
Phone: ^ "
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�, escri.be the scope of work in der 1 I Tear off ri Overlay
I) 3 . .
I st of project: $: -'
e permttge verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) Ali 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) This 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 this application can be
processed,
Ownership of resulting development rights granted by any issued permit inure to the property owner. //j�
Signature - �� Date - ' ''
Metho
O Cash ❑ Check . CiMastercard _ VISA
t .
Bankcard # REDACTEEP ,.c h, .• •i Expires: REDACTED VIN#:
Authorized Signature:
REvIStD arzs2005
his document originally contained
dillib
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
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