2014, 06-20 Permit App: BLD-2014-1442 Tear Off, Reroof .1 k
Community Development Department
Permit Center = (Staff Use Only)
Sc okane 11703 East Sprague Avenue, Suite B-3
n Spokane Valley,WA 99206 1 PERMIT NUMBER:
ValleyTel: (50968 0936 `7.0--5.2yO
Fax: (509) 6888-0037 permitcenteKatsDokanevallev.orq PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
EJ COMMERCIAL RESIDENTIAL
SITE ADDRESS: 1 r 3( S = .A AlrAL�iili ' -i'
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: RECEIv
BUILDING OWNER NAME: A iv - -toJ' 9 m Y1 r ro
NAME: JUN 20 2014
ADDRESS: CSV PERMIT Tz9
STATE: ZIP_ _..... .__.
CITY: S U 3 - . i __1 =. '!
PHONE:
FAX: rip'i _._. ..__,_.. _...
CONTACT NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: ` `
MAILING ADDRESS: �,I,'\-�-elft J A rU �xT`Zf orS vF- T iz,,MN LI- c,�
CITY: "��SF-,,�1k STATE: $0 ZIP: (33 Ly 5`1
rj iv
PHONE: l Ca — 9 s 51 FAX: "ii Pr CELL: 5 pet .tre(.2 6 - /Q
?S-t
CONTRACTOR LICENSE No.: (�.e_A .\-\,\Q__1_3_, IRES: a3 I S CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Tear Off 0 Overlay
TOTAL COST OF PROJECT: $ 4 3 ' el-
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
Information ormation Valley
maypbenrit usred to be submitted permit
dapproval
and subsequently approvedviolation
ordinances. 6) Plans or additional
before this application can be processed.
Signature ____,-
Date: C - )_o- iii
Page 1 of 1
Updated 1-11-11
http://www.spoka neva Iley.org/fi Iestorage/124/938/210/948/1496/2743/Reroof.doc