2013, 04-22 Permit App: BLD-2013-0703 Tear Off, Reroof04/22/2013 4:OOPM FAX 97899522
Spokane
4,00Valley.
ZIEGLER LUMBER 20002/0002
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite 8-3
Spokane Valley, WA 99206
Tel: (509) 688.0036
Fax: (509) 688-0037
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(Staff Use Only)
PERMIT NUMBER: / C C
PERMIT FEE: �� ! `✓— ✓
REROOF CONSTRUCTION PERMIT APPLICATION
Q COMMERCIAL
SITE ADDRESS: 4901 N Lucille
Ell RESIDENTIAL
ASSESSORS PARCEL NO.: 46354.3004 LEGAL DESCRIPTION: SFR
BUILDING OWNER NAME: JIM SPILKER
NAME: --I-10,n SPi lke
ADDRESS: L(9OI N, L.UciL(F
CITY:
SPoKik0E VAct&y
STATE: 1.ft
Zip: 9TZl6
PHONE: 5b9 9zg D'T TI
FAX: CELL:
CONTACT NAME:
PHONE:
FAX: CELL:
CONTRACTOR NAME: Zteylel Lb.nijar. Co,
MAILING ADDRESS: 6,2_6 E //VLLI3L)j3
cm: SPoFins) E
PHONE: 57,7 1-16 L 4I9.60 FAX:
STATE: Oa ZIP: /92I O
5a9 -189- g SZ2
CELL: Se5 ZtL3
CONTRACTOR LICENSE No.: ZIEGLL'316JG
EXPIRES: 8/3/2013 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
REMOVE AND DISPOSE OF CURRENT 3 -TAB ROOFING. RECOVER WITH NEW LAMINATED SHINGLE
REMOVE AND DISPOSE OF CURRENT 3 -TAB ROOFING, RECOVER WITH NEW LAMINATED SHINGLE
El Tear Off
TOTAL COST OF PROJECT: $ 4767.18
[;J Overlay
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) It this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership or this City of Spokane Valley permit inure to the property uwner. 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 Wiley 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 rederal, state orlocal 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
Date: 4/22/13
Method of payment: ❑ Cash D Check
Bankcard #:
❑ Visa ❑ Mastercard
EXP _ VIN#:
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
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10.28.07.doc