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2007, 06-04 Permit App: 07002077 Reroofa Permit Center Spokane 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 jValley. (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Community Development Reroof Construction Permit Application PERMIT NUMBER: — Z 7 3 PERMIT FEE: tit / / S. n Commercial 21 Residential SITE ADDRESS: 13c a e , 5f°4416) Uo 11 eY ASSESSORS PARCEL NO: Building Owner: /� Name: 11 , r a gx,4,/t� l r�/t'm Name: c A�. ` \ v u� Ot 0 City: S -a Ile State:LJ Zip:99da8 Address:i 3 a 5 ' _5 Contractor Lic No42_2_3USR? Date: City:` ,mtVVre. C1 l I e v State: 0 Zip: Phone: q 3-)_ o 15 Fax Contact Person Name: Q ' ca f- 1 4 \ftW (' Phone: ,0`)9_-(2c)c41 Describe the scope of work in detail: e Roc3r Contractor: c�tor: /� Name: 11 , r a gx,4,/t� l r�/t'm Address: p,x I ��0o _ �/� City: S -a Ile State:LJ Zip:99da8 Phone:'77_7d 3- ](v%.? Fax: 509 _ c276, _275d-2 Contractor Lic No42_2_3USR? Date: City Business Lic. No: (o O a Sq 4 30/ 71 Tear off Overlay Cost of project: $ 56 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. Date C.P / 4/U7 Signature Method of Payment: ❑ Cash ❑ Check ❑ Mastercard ❑ VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 8/23/2005 Look Up a Contractor, Electrician or Plumber License Detail Topic Index 1 Contact Info orkplace Rights TTrades & Licensing 1 1 Find a Law or Rule ( j Get a Form or Publication Look Up a Contractor, Electrician or Plumber ; Page 1 of 2 Printer Friendly Version General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License ALLSUSR950RT Licensee Name ALL SURFACE ROOFING/WATERPRFG Licensee Type CONSTRUCTION CONTRACTOR UBI 602546881 Verify Workers Comp Premium Status Ind. Ins. Account Id Business Type CORPORATION Address 1 PO BOX 18806 Address 2 City SPOKANE County SPOKANE State WA Zip 99228 Phone 8777237663 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 12/30/2005 Expiration Date 12/30/2007 Suspend Date Separation Date Parent Company Previous License Next License Associated License https://fortress wa.gov/lni/bbip/Detail.aspx?License=ALLSUSR950RT 6/4/2007 Look Up a Contractor, Electrician or Plumber License Detail Business Owner Information Name Role Effective Datb Expiration Date KIDWELL, JOHN FRANCIS PRESIDENT 12/30/2005 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date #1 WESTERN SURETY CO 70022492 12/20/2005 Until Cancelled $12,000.00 12/30/2005 Savings Information No Matching Information Page 2 of 2 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date #3 LANDMARK AMERICAN INS CO LHA130663 10/20/2006 10/20/2008 $1,000,000.00 04/13/2007 #2 LANDMARK AMERICAN INS CO BNDRGL102006 10/20/2006 10/20/2007 $1,000,000.00 10/18/2006 LANDMARK AMERICAN INS CO LHA128823 10/20/2005 10/20/2006 $1,000,000.00 06/13/2006 Summons / Complaints Information No Matching Information Start a New Search Printer Friend y Version aco i» w About L&I I Find a job at L&I 1 InformaciOn en espanol I Site Feedback 1 1-800-547-8367 0 Washington State Dept. of Labor and Industries. Use of this site is subject to the lawn of the state of Washington. Access Agreement 1 Privacy and security statement 1 Intended use/external content policy 1 Visit access.wa.gov Staff only link a rftt- 0S https://fortress.wa.gov/lni/bbip/Detail.aspx?License=ALLSUSR95ORT 6/4/2007