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2012, 10-02 Permit App BLD-2012-1717 Re-RoofPHONE: Spokane 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 oermitcenter©sookanevalley.orp c).ZNZ-1-71-1 (Staff Use Only) PERMIT NUMBER: /1 PERMIT FEE: 11. 'J REROOF CONSTRUCTION PERMIT APPLICATION l]! COMMERCIAL SITE ADDRESS: RESIDENTIAL ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: NAME: ADDRESS: Cm: PHONE: • ---(77 5. . CONTACT NAME: 0 /\\ ,k_ PHONE: FAX: FAX: STATE: CONTRACTOR NAME: Y1 ' MAILING ADDRESS: / zIP: 9 7.-2d,2 CELL: CELL: f� s Q S CITY: '�-i uW I t, / STATE: //0r/1_ ZIP:. 79v20-6- 0 FAX: �/' - p G a_ccELL: CONTRACTOR LICENSE No.: C 40 (KR CZ (731' J EXPIRES: DESCRIBE THE SCOPE OF WORK IN DETAIL AN 02 0! CITY BUSINESS LICENSE NO.: INDICATE USE: e _Ckle-a; Off TOTAL COST OF PROJECT: $ DISCLAIMER The permitted verifies, acknowledges and agrees by their signature be served by potable water. 2) Ownership of this City of Spokane owner or has permission to represent the pro•erty owner in this tra Spokane Valley Development code. - -renced des are a Spokane Valley permit is not olati°. information may be re. to miffed aently app ❑ Overlay that: 1) if this permit is for construction or on a dwelling, the dwelling is/will Valley permit inure to the property owner. 3) The signatory is the property •fsaction. 4) All construction is to be done in full compliance with the City of le for review at the City of Spokane Valley Permit Center. 5) The City of of federal, state or local laws, codes or ordinances. 6) Plans or additional oved before this application can be processed. Updated 1-11-11 Page 1 of 1 http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit 1-11-11.doc