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2003, 07-01 Permit: BLD-03-02011 ReroofSlioliane` Val ley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 RESIDENTIAL ADDITION/REMODEL Job Address: 13019 E 23RD AVE SPOKANE WA 99216-0302 Description: RE -ROOF Subdivision: Lot No: Owner: Applicant: Address: Contractor: Address: WALKER, R R HENDERSON ROOFING 1330 S PINES RD SPOKANE VALLEY, WA HENDERSON ROOFING 1330 S PINES RD SPOKANE WA 99207 & CONST INC Phone: (509) 928-7254 99206 & CONST INC Phone: Lic No: (509) 928-7254 HENDERC995MS Permit #: BLD -03-02011 Applied: 07/01/2003 Issued: 07/01/2003 Expires: 12/28/2003 General Information: VALUATION SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY 3705 no no Fees: PLAN CHECK FEE BASIC PERMIT FEE WSBCC SURCHARGE Total Calculated: Deposits/Receipts: Total Due: 19.45 97.25 4.50 121.20 121.20 0.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations goveming this type of work will be in compliance, Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Ownership of resulting development rights granted by any issuii10 the property owner. .?\(Fx1M1 liktoui 4 Applicant Please print name here Date ounter Approv _ t EL %gear L L �..s. �.� L ` L i �. L i Namd (.t t.- r aria Cc L•• .. �~ • LICENSED • INSURED • BONDED • HENDERC995MS 1003 S. PINES RD. SPOKANE, WA 99206 PHONE (509) 92&-7254 FAX (509) 928-8020 S What is JOB SITE address? OWNER or OCCUPANT untv Building Pe 10 • Bro.• a S s okan ` ` 60 477-3675 Fax: 477-7198 Center /3z/Y Z 23'4" 1/-ffricot Who should we contact regarding this project? RE -ROOF $ ,7 7G' )-- Phone 7 V. PERMIT $ 42/- Contractor Henderson Roofing and Construction. Inc. WA State Contractor License # HENDERC995MS Mailing address 1003 S. Pines Rd., Spokane, WA. 99206