2014, 07-22 Permit App BLD-2014-1739 Re-RoofCommunity Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688--89J6 -7 O— 52 9%0
Fax: (509) 688-0037
Dermitcenter sookanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL �} � 0 RESIDENTIAL n _-
SITE ADDRESS: (`lc( a 0 £ ISfC LOt'' f
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: € N`c_ Se.we,11
.JL 2Z2014
NAME: CC I cG= Se_ .e / U5v PERMIT CENTER
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ADDRESS: ` (D c . ✓ t9 J
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CITY: P 0V . Oa-1 STATE: I ZIP: E
PHONE:
FAX: CELLL:
CONTACT NAME:
PHONE:
cz .%(39V
Co c c rs J �r4v4-4f-Sd-�
FAX: 9. 4- t-10 (C CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
I C, 0
Cm: spk V �I '1r
PHONE: pL �( 8'y FAX:
STATE:
CELL:
ZIP: 9 I J
CONTRACTOR LICENSENO.: { ICIc 933'"'i .EXPIRES: 6,40/S CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
U!`Tear Off
TOTAL COST OF PROJECT: $ 33 co
❑ 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 wnership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to re re nt the property owner In this transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Developmen 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 perms: or-pprovai for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to b- suj)mi ed and subsequently approved before this application can be processed.
Signature
Date:
Updated 1-11-11 Page 1 of 1
http://www.spoka neva I ley.org/fi lestorage/124/938/210/948/1496/2743/Reroof.doc