2010, 09-21 Permit App: 10002994 Tear Off, ReroofSpokane e
#Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevalley.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE: Il tz-
REROOF CONSTRUCTION PERMIT APPLICATION
El COMMERCIAL ® RESIDENTIAL
SITE ADDRESS:1825 S. BLAKE Ro.; SPOKANE VALLEY, WA 99216
ASSESSORS PARCEL NO.:45271.1144 LEGAL DESCRIPTION:VERA S2/3 OF N3/5 OF W1/2
OF TR 192 EXC N143.60FT M/L OF W252.80
BUILDING OWNER NAME: EDWARD A MILLER
NAME:EDWARD A MILLER
ADDRESS:1825 S BLAKE RD
Cm:SPOKANE VALLEY
PHONE:509-926-0153
STATE: WA
ZIP:99216
Fax:
CELL:
CONTACT NAME:CAROL MILLER
PHONE:509-926-0153 Fax:
CELL:
CONTRACTOR NAME:SELF
MAILING ADDRESS:
Cm:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
REMOVE THE ONE LAYER OF OLD THREE -TAB ASPHALT SHINGLES AND TAR PAPER DOWN TO ROOF DECK. APPLY DRIP EDGE,
ICE SHIELD, TAR PAPER, AND ARCHITECTURAL STYLE ASPHALT SHINGLES.
PERSONAL USE
® Tear Off ® Overlay
TOTAL COST OF PROJECT: $2585.00
pISCLAIMER
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 be submitted and subsequently approved before this application can be processed.
•
Signature (rs-e //4¢ Date:
Method of payment: 0 Cash
0 Check ❑ Visa
Bankcard #: EXP:
❑ Mastercard
VIN#:
Authorized Signature: