2014, 04-04 Permit App BLD-2014-0674 Re-RoofPermit Center
C nfOrtOne 11703 E Sprague Ave, Suite 3
p svv Spokane Valley, WA 99206
V e = (509)688-0036 FAX: 0509)688-0037
wwwspo3canevaley.org
Community Development .
Reroof Construction
Permit Application
AdOD �
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial
Residential
SITE ADDRESS: i i ')-X3 -a, 4tL Ai/ OrJ'• ''vQV GZ(u' q q o d ((J'
ASSESSORS PARCELNO
Building Owner_
-
Name:
1.
)
Pilrk A -P
r(9
Address
City:
State:
Zip:
Phone:
Fax:
Contact Person -
Name: \ 1 u
Phone: / " ;2 -, ,4 g
Describe the scope of work in detail:
Contractor::. •
.
. - • Morris Clerk Siding & Rooting
Name: 2728 E Garland
spo WA 99207
Address: 482-2833
City_
State` Zip:
Phone: 7 /,,,g;2,,
Fax: 7,1 �� 7
7 _
Contractor Lic No: -
`!'Yl e' 2-e-I e.S 67 (..
Exp Date:
2A J 0 to -�
-
City Business Lic. No:
Tear off f Overlay
Cost of project: $ ! Leta-°, 00
The permitee verifies, acknowledges and agrees by their signature that 1) If this permit is for construction of or on a
dwelling, the dwelling isfwill 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) This 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 be submitted, and subsequently approved before this application can be
processed.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Signature
Method of Payment:
❑ Cash •
Bankcard #:
❑ Check
REDACTED
❑ Mastercard
�v�rres�
This document originally contained confidential credit card
information which was redacted pursuant to RCW 19.255.010
and the original document destroyed pursuant to SOS DAN
GS2014-030.
I. U
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Date
Project # tLDON c 7
❑ VISA-CEIVED •
REDACTED IWO 4 2014
CSV PERMIT CENTER
SUB# 1 REV,#
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