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2003, 08-26 Permit: BLD-03-02320 Reroof11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 RESIDENTIAL ADDITION/REMODEL PERMIT Job Address: 2204 S BURNS RD VERADALE WA 99037 Description: REROOF Subdivision: Owner: Applicant: Address: Contractor: Address: HJORTEDAL, DONALD E HENDERSON ROOFING 1330 S PINES RD SPOKANE VALLEY, WA HENDERSON ROOFING 1330 S PINES RD SPOKANE WA 99207 Lot: Permit #: BLD -03-02320 Applied: 08/26/2003 Issued: 08/26/2003 Expires: 02/22/2004 131k: Parcel No: 45261.2301 & CONST INC Phone: (509) 928-7254 99206 & CONST INC Phone: Lic No: (509) 928-7254 HENDERC995MS Zoning: General Information: VALUATION REROOF SERVED BY SEPTIC SYSTEM „. WELLS LOCATED ON PROPERTY 4060 Y no no Fees: BASIC PERMIT FEE WSBCC SURCHARGE Total Calculated: Deposits/Receipts: Total Due: 11125 4.50 115.75 115.75 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 issued permit inure to the property owner. Applicant Please print name here Date Counter Approval fr I rte. [n (". • 6 f and Constr;, ct[on. LICENSED • INSURED • BONDED • HENDERC995MS 6343X 1003 S. PINES RD. SPOKANE, WA 99206 PHONE (509) 921,-7254 FAX (509) 928-8020 S okan ountv Buildina Per enter A. 99260 47 675 Fax: 477- ' 8 What is JOB SITE address? L. k Av`c\Zoc-N 5 • Who should we contact regarding this project? OWNER or OCCUPANT Phone RE -ROOF $ �--� ( 0 C'2-2 '2- PERMIT S =' Contractor Henderson Roofing and Construction, Inc. WA State Contractor License # HENDERC995MS Mailing address 1003 S. Pines Rd., Spokane, WA. 99206