2013, 09-09 Permit App: BLD-2013-7791 Tear Off, Reroof Kodiak Roofing Co Inc 15095331292 p.1
Community Development Department
Permit Center (Staff Use Only)
SpoiiTIY 01 ane 11703 East Sprague Avenue,Suite B-3
Spokane Valley, WA 99206 PERMIT NUMBER: `N./1 -..'0I 01;1 I
Tel: (509) 688-0036
.. Valley . Fax: (509) 688-0037 PERMIT FEE:
REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL 0 RESIDENTIAL /�
SITE ADDRESS: 6422E 4th St ,5a`T"d 1 "[o ( q
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: Renee Mehl
NAME:
ADDRESS:
Spokane WA STATE:WA 213-09202-----�
CITY: p ?71-9-?71-9- D-0(3 L/
6
509-487-9910 FAX: 509-533-129 Project o j e ct�LL:
PHONE: I RECEIVED
CONTACT NAME: i
PHONE: 509-487-9910 FAx:509-533-1294 CEL;: y 0 ni-14,, /32/ —
CONTRACTOR NAME:
Kodiak RoofingCo Inc. CSV PERMIT CENTER
MAILING ADDRESS:
ter: Spokane WA STALE WA SUB # R99292!
PHONE: 509-487-9910 FAX:509-533-1292 • CELL
CONTRACTOR LICENSE No.:KODIARC000B4 EXPIRES:01/31/2014 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
3 layer tear off reroof IKD 30 yr
3 layer tear off reroof IKO 30yr
Q Tear Off 0 Overlay
TOTAL COST OF PROJECT: $ 9000.00
DISCLAIMER
The permitted verifies,acknowledges and agrees by their signature that: 1) if this pe*mit is far construction o-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 fcr 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 required to be submitted and subsequently approved before this application can be processed.
Signature Date: 09/07/13
Method of payment: ❑ Cash 0 Check ❑Visa 0 Mastercard
Bankcard #: Exp:01/31/2014 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