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2011, 04-19 Permit App: 11000996 Re-Roof Community Development Department Permit Center (Staff Use Only) cirYOH 11703 East Sprague Avenue, Suite B-3 p0ile, Spokane Valley, WA 99206 PERMIT N BER: II-- Cr-19 Tel: (509) 688-0036 �__ Valley. Fax: (509) 688-0037 PERMIT FEE: 7� permitcenter©spokanevallev.orq REROOF CONSTRUCTION PERMIT APPLICATION Q COMMERCIAL i.RESIDENTIAL SITE ADDRESS: di Z S C4r-v.7,J ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: Min C y S M.2 7/a NAME: m Q n ',.Y SM 7-77.4 ADDRESS: 12 5 C 4 i v.2, CITY: 5 pe, VACLG Y STATE: ("/A ZIP: PHONE: ,SG)9- G.9 0 — 95 93 FAX: CELL: CONTACT NAME: 3 cv - gA S/^^aiIZt? PHONE: SO9 9S y - q /s FAX: CELL: CONTRACTOR NAME: 2jL?„)Z -/7,el-M2/,,6 d 6. n)Croq� Ca/yr/7,4c7fNG ,?i,,c • MAILING ADDRESS: p.O. Zc,x 3)ZI) CITY: S po -c N 2� STATE: (AM ZIP: % Z 3 PHONE: SOr/.- 9S3^Lig/$ FAX: CELL: • CONTRACTOR LICENSE No.: IfJ -7N/^4 kkgaP EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: ILL= ROOF ,4 i•-)c�,SE , n7 e., "TC/_f it c/F—F Tear Off El---- Overlay TOTAL COST OF PROJECT: $ 2 ; ex) cc, / 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 require e submitted and sequently approved before this application can be processed. Signature -.-- Date: y:// Updated 1-11-11 Page 1 of 1 http://www.spoka neva l ley.org/fi lestorage/124/938/210/948/1496/Reroof_perm it_1-11-11.doc