2013, 05-13 Permit App: BLD-2013-0860 Tear Off, Reroof l,4Z—Z )/3-4 86,61
• Permit Center PERME NU'M)3ER:
' �� t 1703 E Sprague Ave,Suite 13-3
Spokane Spokane Valley,WA 99206 PERMIT FEE: t /9't-7,y
aij�` (509)688-003G PAX:(509)688-0037
-'J www.Stzokanevallev.org / / 5
Community Development COPY Jr"
Reroof. Construction n Com crclal
esadcntial
Permit Application C .✓---
SITE ADDRESS: I ( 3 1 5 E
2.5
ASSESSORS PARCEL NO:
Building Owner: Contractor: ,,
Name: r i — Name: ` � 00Alb '�,r�t 1 rit�r Dor
ASdn 5R: i .nk Address: ) ....� '14
t13I $ �z.5 _
',` ` State:
City: State: 3 Zip: �i f�(n City:svo1� ve- (.b.�x zip:
Phone:
dlotS .5(,( Fax: Phoner43„ --u L`' Fax. "► ' i!
Contractor Lic No)^3 Exp Date: 61
6
Contact Person City Business Lic.No:
Natne: ,3 a
Phone: q')41 -• '$L19 3
"Describe the scope of work in de Tear off r1 Overlay
Cost of project: $ .- i�1 2,2:2. . 3 1
r
pert nftne verifies, acknowledges and agrees by their signature that 1) If this permit is for construction of or on a
dwell 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) 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.
Signature Date
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard VISA
Bankcard#: r REDACTED „REDACTED VIN#: REDACTED
'
Authorized Signature:
REVISFn p/23n005 ik This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
imromo
and the original document destroyed
pursuant to SOS DAN G52014-030.
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