2011, 08-09 Permit App: 11002377 Tear Off, Reroof 7/ . Community Development Department
Permit Center (Staff Use Only)
Spokane
un Spokane Vas yaWA=le, Suite B-3 PERMIT NUMBER: H �,��
Tel: (509) 688-003641• 17
Valley Fax: (509) 688-0037 PERMIT FEE: `]
permitcentert spokanevalley.oro
REROOF CONSTRUCTION PERMIT APPLICATION
El COMMERCIAL RESIDENTIAL
SITE ADDRESS: (3 Z2 I 2-41' AO se_
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME:
NAME: 6n
ADDRESS: r ")ZZ i E• � `c /-tom �— t ^ c1�
CITY: (✓oKA--'& V ` p STATE: W 4- ZIP: '7 / 1,
PHONE: 50rf - 66e-6666, —(22j.1 FAX: CELL:
CONTACT NAME: Dekt i Lk WC-L.4VC Lir,
PHONE: 5O9- c �� - 7 , 1 FAX: CELL:
CONTRACTOR NAME: i ,q c)). /7 -tee- e/ 6{5/h 55 _e✓vi Z.es LQ__
• MAILING ADDRESS: .17.—(2_4 e r
CITY: Ir!l tl� ..JA-A•1(..JA-A•1( ! STATE: (. V ZIP: qq)-- (
-L=
PHONE: t"6-6-3/ „5-":16 " 7L, i'/ FAX: CELL:
CONTRACTOR LICENSE NO.:6DI-Ite4 DI-It3 EXPIRES: i/ 3/ DI Z CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE Of WORK IN DETAIL AND INDICATE USE:
'�,q ,f Jfbc�- vv� Siv�itic �t ce — ZiS .1I 51,e-4-4-1,--ct=�L l i 34,5
p 1 � i
`f 7`i. /✓1 ' J t-x'/S"/ __// �.k. `-�/ 1�/�kl�^-/1q E. 1/i'YY� v i�-e 4D e� 1 TU �-C C e.$S
(1) -[-o T' A` U-/S h i—t " -
Tear Off 4 El Overlay
TOTAL COST OF PROJECT: $ 7 .(0,-.1
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 may be required to be submitted and subse. -ntly approved before this application can be processed.
Signature ( A( _ Date: c/91-011
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