2013, 09-16 Permit App: BLD-2013-1872 Tear Off, Reroof •
! Community Development Department
Permit Center (Staff Use Only)
Spokane 11703 East Sprague Avenue, Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:
Valley Tel: (509) 688-9936-- 720-5.2 VO
Fax: (509)688-0037 PERMIT FEE:
permitcenterPspokanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
EE COMMERCIAL RESIDErITIAL q--0\. l�/V-
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SITE ADDRESS: p. F ; I
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: : e r. et . 7i
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NAME: _2,-0 `r\..f u '
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ADDRESS: // 6((7 5t ,)-c
CITY: ,( V`r't G.((L? ✓✓STATE: s I !C +
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PHONE: FAX: CELL: • •
CONTACT NAME: -
PHONE: FAX: y CELL:
CONTRACTOR NAME: CA 1/4.3-E/k— �,�-ev—pl�f✓jb--t,•'1 •
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' MAILING ADDRESS: •eiV\ -^-C l' `e( $inVcp-04.f— , _ /00 -2? re,,,
CITY: VIQc.{_ UCs—_S/ ((� STATE: ZIP:. Q "
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PHONE: . 7_.e ,6 FAX: • CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
•
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
ear Off / d Overlay
TOTAL COST OF PROJECT: $ ir 77 C�
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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 repress , the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Developmen .de. Referenced -,es are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is -. a perm or .• • =.'or any v•.lation of federal,state or local laws,codes or ordinances. 6) Plans or additional
information may be -.uired to be ■-. --. subsequen approved before this application can be processed.
Sign-.is /' ' _ Date: /^"� f/
swoori 411111
Updated 1-11-11 • Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc