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2013, 07-10 Permit App: BLD-2013-1354 Tear Off, ReroofSta e .00Valley Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenterPsooka neva Ilev.orq ete-u73-1%g (Staff Use Only) PERMIT NUMBER:{{�tR�I- PERMIT FEE: 't6. // 1b REROOF CONSTRUCTION PERMIT APPLICATION COMMERCIAL 0 RESIDENTIAL SITE ADDRESS: 8420 EAST NORA AVE., SPOKANE VALLEY, WA. 99212 ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: JAN CARLSON NAME: SAME ADDRESS: Cm: STATE: ZIP: PHONE: 509-230-8654 FAX: CELL: CONTACT NAME: JAN CARLSON PHONE: 509-230-8654 FAX: CELL: CONTRACTOR NAME: JAN CARLSON MAILING ADDRESS: SAME Cm: STATE: ZIP: PHONE: 509-230-8654 FAX: CELL: CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: REMOVE AND REPLACESINGLE LAYER OF ASPHALT SHINGLES/TAR PAPER FROM ROOF VENT EXISTING KITCHEN/BATH EXHAUST FANS TO ROOF VENT. REMOVE AND REPLACESINGLE LAYER OF ASPHALT SHINGLES/TAR PAPER FROM ROOF ■❑ Tear Off El Overlay TOTAL COST OF PROJECT: $ 4,900 }1ISCLAIMER 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 re.uired to be su itted and subsequently approved before this application can be processed. t 1 . ,.y Signatur Date: 7/10/13 Method of pa ment: 0 Cash Bankcard #: 0 Check 0 Visa 0 Mastercard EXP: VIN#: Authorized Signature: Effective October 28, 2007 Page 1 of 1 P:\Community Development \02 Administration\03 Forms - Official Versions\Permit Center\Reroof Construction Permit App 10.28.07.doc 5 10 15 20 25 5 F6 MONTHS BY DAYS X 120 DIVISIONS IfllBF= KEUFFEL & ESSER CO. RADE IM USA 10 15 20 25 5 10 15 20 25 5 10 15 20 46 2610 25 5 10 15 20 25 5 10 15 20 25 ImIll y 77777■■C7?::1C7:lnCll:n::•�? C 1 .w 1111111. l0i0i1lEEi I! 1::::lllla:■i�i:a11::C'_:;; .rCC X... ■.... ........ 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