2004, 06-21 Permit: BLD-04-04643 Re-RoofSpokane
. , Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
RESIDENTIAL ADDITION /REMODEL PERMIT
Job Address: 9721 E ARCHERY AVE
SPOKANE WA 99206 -3548
Description: TEAR OFF AND RE -ROOF
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
WEBSTER, JOHN D
Permit #:
Applied:
Issued:
Expires:
BLD -04 -04643
Lot: Blk: Parcel No: 45203.1314 Zoning:
N PERRENOUD ROOFING Phone: (509) 994 -6795
219 S HOGAN ST
SPOKANE, WA 99202
N PERRENOUD ROOFING
219 S HOGAN ST
SPOKANE WA 99202
Phone:
Lic No:
nperrr"99011
06/21/2004
06/21/2004
12/18/2004
General Information:
VALUATION
REROOF
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
3400
Y
no
no
Fees:
BASIC PERMIT FEE
WSBCC SURCHARGE
Total Calculated:
Deposits /Receipts:
Total Due:
97.25
4.50
101.75
101.75
0.00
Disclaimer:
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This City of
Spokane Valley Permit is not a permit or approval for any violation of federal, state or local I_ s, codes or ordinances.
Ownership of resulting development rights granted by any issued permit)
Print Name Signature
Staff Initials
THIS IS NOT A RECEIPT
y owner.
6x10
Date
SpouThane
4,0"alley
ts 3
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11 707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688 -0036; Fax: (509) 688 -0037
REQUIRED SITE INFORMATION
Street Address: (-17,7 1 F P f/ rl ely
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
n Building Permit
(1 Relocation
re—roo
P Change in Use
II
II
I1
Grading
I
Manufactured Home
Tenant Improvement Fire Safety 1 1 Other
OWNER/APPLICANT INFORMATION
n
Owner: a.D Y1 C\ We< 1SCCs
Phone: Q6,- ().77 Fax:
Address: �f
r1w P
City State
Zip Code
I-1 Contractor: Pecie06(,0, (200 In
Phone: Fax:
Address:
TI Applicant:
Phone:
Address:
Fax:
City
E Architect:
Phone:
Address:
State Zip Code
Fax:
City State Zip Code City State Zip Code
WA State Contractor License #: I U QR l9GLLContact: I ft"@/lf LC J 99J - rK
PERMIT /BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2 "" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: `y) pO
VV
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: Length: Year:
Manufacturer:
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent: Fireworks Display: Blasting:
Valuation: Above /Underground Storage Tank Size:
Paint Booth:
Date/Time:
WASHINGTON STATE NON- RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State Zip
SPECIAL INSPECTIONS
fl BOLTING n CONCRETE
Fl REINFORCEMENT n WELDING
Firm Name: Phone:
Inspector(s):
Fax:
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or or nances.
Ownership of resulting development rights granted by any issued permit inure the p% rty owner.
Print Name �J ► °1AA �C ( /el^ Ok Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check (l Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN #:
Authorized Signature: