2008, 07-21 Permit App: 08002817 ReroofPermit Center
*wane
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
jdoValley. (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Reroof Construction
Permit Application
SITE ADDRESS:
PERMIT NUMBER: '8 r'
PERMIT FEE:
Commercial
Residential
5C2 5 n Czc
Rd Sp61�-
ASSESSORS PARCEL NO: 35,/, 09067
Building Owner:
Name:
,,
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-(,0P%(u,
Address:
Address:
City:
State:
Zip:
Phone:
Fax:
Fax:
Contact Person
Name:
We ) ua-t) - (r d(^
Phone:
509 pi -8555 WM_
Contractor:
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
Q
Describe the scope of work in detail: n Tear off
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x
Overlay
Cost of project: $ < /e 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 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 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 ,C� i C�/ a J ILC th - Date/ i/os)-
Method of Payment:
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective October 28, 2007
Page 1 of 1
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*Wane
ley
PERMIT CENTER
11703 E. Sprague Ave., Suite B-3
Spokane Valley, WA 99206
509-688-0036; Fax 509-688-0037
www.spokanevalley.org
Affidavit in Lieu of General Contractor Registration
State of Washington
County of Spokane
(Print name as signe
1. I have made application for a building permit from the City of Spokane Valley, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under RCW 18.27.090, a copy of
which is printed on the reverse side of this affidavit.
ows:
3. I understand that prior to issuance of a building permit for work that is to be done by any contractor,
the City of Spokane Valley must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Spokane Valley of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. /;2. , and will
therefore, not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any
decision to engage an unregistered contractor to perform construction work.
APPLICANT'S SIGNATURE
�1j11\\\\\\\\-•
Slped and sworn to before me this
I Day of 20P
L_
\Mak
' Name � (Print)�
VI3
tary Signature
NOTARY PUBLIC in and for the State of
Washington, residing at 4 1^'' 'County
My Commission expires:
-V-11
October 15, 2007 Page 1 of 2
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Revised Code of Washington
18.27.090 Exemptions. The registration provisions of this chapter do not apply to:
1) An authorized representative of the United States
government, the state of Washington, or any
incorporated city, town, county, township, irrigation
district, reclamation district, or other municipal or
political corporation or subdivision of this state;
2) Officers of a court when they are acting within the scope
of their office;
3) Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their
own business;
4) Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground
mine or mineral deposit when performed by an owner
or lessee;
5) The sale or installation of any finished products,
materials, or articles of merchandise that are not actually
fabricated into and do not become a permanent fixed
part of a structure;
6) Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile/manufactured home retail dealer
or manufacturer licensed under chapter 46.70 RCW who
shall warranty service and repairs under chapter 46.70
RCW;
7) Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8) Any person who only furnished materials, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9) Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential
nature. The exemption prescribed in this subsection does
not apply in any instance wherein the work or
construction is only a part of a larger or major operation,
whether undertaken by the same or a different
contractor, or in which a division of the operation is
made into contracts of amounts less than five hundred
dollars for the purpose of evasion of this chapter or
otherwise. The exemption prescribed in this subsection
does not apply to a person who advertises or puts out
any sign or card or other device which might indicate to
the public that he or she is a contractor, or that he or she
is qualified to engage in the business of contractor;
10) Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is
performed by a registered contractor;
11) An owner who contracts for a project with a registered
contractor, except that this exemption shall not deprive
the owner of the protections of this chapter against
registered and unregistered contractors. The exemption
prescribed in this subsection does not apply to a person
who performs the activities of a contractor for the
purpose of leasing or selling improved property he or
she has owned for less than twelve months;
12) Any person working on his or her own property, whether
occupied by him or her or not, and any person working
on his or her personal residence, whether owned by him
or her or not but this exemption shall not apply to any
person otherwise covered by this chapter who constructs
an improvement on his or her own property with the
intention and for the purpose of selling the improved
property;
13) Owners of commercial properties who use their own
employees to do maintenance, repair, and alteration
work in or upon their own properties;
14) A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician licensed under the laws of the state of
Washington, or a plumber licensed under the laws of the
state of Washington or licensed by a political
subdivision of the state of Washington while operating
within the boundaries of such political subdivision. The
exemption provided in this subsection is applicable only
when the licensee is operating within the scope of his or
her license;
15) Any person who engages in the activities herein
regulated as an employee of a registered contractor with
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
16) Contractors on highway projects who have been
prequalified as required by RCW 47.28.070, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
17) A mobile/manufactured home dealer or manufacturer
who subcontracts the installation, set-up, or repair work
to actively registered contractors. This exemption only
applies to the installation, set-up, or repair of the
mobile/manufactured homes that were manufactured or
sold by the mobile/manufactured home dealer or
manufacturer;
18) An entity who holds a valid electrical contractor's
license under chapter 19.28 RCW that employs a
certified journeyman electrician, a certified residential
specialty electrician, or an electrical trainee meeting the
requirements of chapter 19.28 RCW to perform
plumbing work that is incidentally, directly, and
immediately appropriate to the like -in-kind replacement
of a household appliance or other smallhousehold
utilization equipment that requires limited electric power
and limited waste and/or water connections. An
electrical trainee must be supervised by a certified
electrician while performing plumbing work.
October 15, 2007 Page 2 of 2
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