2015, 04-27 Permit App: BLD-2015-0935 Re-RoofCommunity Development Pepartment
Permit Center 4%(Staff Use Only)
sCITY 11703 East Sprague Avenue, Suite B-3
pWall1v Spokane Valley, WA 99206 PERMIT NUMBER:
Valley Tel: (509) 688-0036
'� Fax: (509) 688-0037 PERMIT FEE:
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permitcenter@sooka nevallev.org
REROOF CONSTRUCTION PERMIT APPLICATION
CQ COMMERCIAL 2RESIDENTIAL %
SITE ADDRESS: 3(,/5 RECEIVED
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: . 7—m
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NAME: CSV PERMIT CENTER
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ADDRESS: ` ra o Ty\ r -3E V.
CITY: CjQ v ... t — 7 STATE: 'f Jq zIP: �f���
PHONE: / FAX: CELL:
CONTACT NAME:
PHONE: ` FAX: n CELL:
CONTRACTOR NAME:
MAILING ADDRESS: &, O)– s, q".L/ �2— 7 J
CITY: / STATE: t�p� ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
ZI Tear Off Overlay
TOTAL COST OF PROJECT:
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 o r in this transaction. 4) All construction Is to be done in full compliance with the City of
Spokane Valley Develo Referent es areji
ailab�of
for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley p is not a per it�d/d
for any 'la
Spokane federal, state or local laws, codes or ordinances. 6) Plans or additional
Information be required Mae suubsequ before this application can be processed.
Date:
5
Updated 1-11-11 Page 1 of 1
http://www.spokaneva Iley.org/fi lestorage/124/938/210/948/1496/Reroof_Permit_1-11-11.doc