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2014, 04-01 Permit App BLD-2014-0626 Re-RoofSpokane Valley Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenter@spoka neva Iley.orq (Staff Use Only) PERMIT NUMBER: PERMIT FEE: REROOF CONSTRUCTION PERMIT APPLICATION 0COMMERCIAL SITE ADDRESS: ASSESSORS PARCEL NO.: )CRESIDENTIAL LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: /1/ G e�62 / �/ . ADDRESS: _3 5 // 5 - Q C 4) CITY: , 55 e, ,e-B',,7 f, 6/ '"- /,C';' STATE: 1,5 S ,E IP: e y2 V PHONE: �C 9 - - /7 cj7 FAX: CELL: CONTACT NAME: �q/ j, /1)/ Av/? �9 PHONE: 2. 3 ' 6 , 3 Q A FAX: CELL: F ! /- 1/2172- CONTRACTOR NAME: MAILING ADDRESS: Crry: STATE: . ZIP: PHONE: FAX: CELL: CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: Tear Off TOTAL COST OF PROJECT: $ 3 _s---p _ ©P7 Overlay 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 riot 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 Sgbmitted and subseently ,proved before this application can be processed. Signature Date: �j�- d/- / Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit 1-11-11.doc