2015, 06-03 Permit App BLD-2015-1297 Re-RoofSpokane
jvalley°
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
Dermitcenter@sookanevalley.org
-(Staff1tseeOnly)
PERMIT NUMBER: E II
PERMIT FEE: I IN 0 3 2O1
CSV PERMIT CENTER
REROOF CONSTRUCTION PERMIT APPLICAT. ON
COMMERCIAL RESIDEN
SITE ADDRESS:
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME:
!IL( tf.
q2cou ADDRESS:u0 r j
CITY: S/ 0,) 6
r,
PHONE: OF - F/Y s-(90
CONTACT NAME: /,aAt
PHONE:
CONTRACTOR NAME:
STATE:
FAX: CELL:
ZIP: ?Foy 6
FAX: CELL: S�I�l�. �96.-LS,
MAILING ADDRESS:
CITY:
STATE:
ZIP:.
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
rTear Off [[ Overlay
OTAL COST OF PROJECT: $ 3 cob
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 required to be5ebmitted and subsequently approved before this application can be processed.
Signature
Date: _ 3 % �~
17
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Reroof Permit_1-11-11.doc