2007, 01-31 Permit App: 07000288 Tear Off, Reroof ` Permit Center
2 a
Spokane 11707 E Sprague Ave,Suite 106 r '�P- r4 „
Valley Spokane Valley,WA 99206
(509)688-0036 FAX: (509)688-0037 `&S t� k
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Community Development ww'w.spokanevalley'.org.coin
Reroof Construction ❑ Commercial
Permit Application ,Residential
SITE ADDRESS (f/41 2_ F; 1
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
- - r
Budm ::owner = _ , , Cont%-actor .
Name: G- o CJ GA F o GC, 0 Name: T 0013 coywe
Address: (j1 L/l Z E_-c, q Address: r , ,"
City: l 1 j
(�A-1,.- - - Zip: e' qzi Z City: 9) Zip: i 2-/ 7
Phone: £j 5..y(%/5 Fax: Phone: 4-1y1-30y1( Fax: 9' l - ?.j(.,l3,6
Lic No VC66,) ,9 op Exp.Date: 7 Jo 7
Collta13;PersO i 4, ,. ,-ffr : City Business Lic No: 3 Zen 0 5 Lo 7 Sr
Name:
Phone:
Describe the scope of work in detail: Tear off 0 Overlay
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I ►x ` 4-4/ _I O 414 . Lt . 4i1 Uc / s
Cost of project S j 2,0-00,D1)
DISCLAIMER
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.
t.
Signature . 1 - 6 Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: ,
REVISED 8/23(2005
;nternet Master Business Application Page 1 of 3
`w Master License Service
.,, Department of Licensing Master Business Application Record of Filing
� `r P O Box 9034
Olympia WA 98507-9034
Congratulations! The application has been submitted with the following information. Print this page for
your records. This is your receipt.
If you find any mistakes, please enter your corrections on the next screen.
Filing information
Filing Date and Time: Jan 31 2007 3:12:04:000PM Pacific Time
UBI Issued:
Application Transaction#: 20070315581
( cf r to this ;umber If you have questions about this app!cat/on.
Credit Card Approval#:
Last 5 digits of Credit Card#: iLPP
Credit Card type: Master Card
Purpose of Application
Add City License to Existing Location
Ownership Structure
Ownership Structure: Sole Proprietor
Federal Employer ID Number This document originally contained
(FEIN): 910860855 confidential credit card information which
was redacted pursuant to RCW 19.255.010
Unified Business ID (UBI): 328053675 and the original document destroyed
pursuant to SOS DAN G52014-030.
Business ID:
Location ID:
Business Location Address: 9927 E. Garland
Business Location City: Spokane
State: WA
Governing Person(s)
Person 1:
Title(s): Owner
Name: DANNY R BAIN
Phone: (509)489-3684
Birth Date: 07/15/1948
SSN: 534-50-0200
Address: 9927E. Garland
Spokane, WA 99206
Does this Governing Person have
a spouse? Yes
https://fortress.wa.gov/dol/mis/Main.aspx 1/31/2007
• Internet Master Business Application Page 2 of 3
Spouse Name: JEANNETTE R BAIN
Spouse Birth Date:
Spouse SSN:
Should the spouse's name appear
on the license? No
Business Information
Business Firm Name (doing
business as): THE DRB COMPANY
Mailing Address: PO BOX 6168
SPOKANE, WA 99217
Is this application for a business
with a Washington State location? Yes
Will you have employees working
in Washington State within 90
days? Yes
Business Location Information
Location Address: 9927 E GARLAND
SPOKANE, WA 99206
Is this business located within the
city limits? Yes
Do you want a separate tax return
for each location or trade name? No
Close Address: E. 3727 Joseph
P.O. BOX 6168
Spokane, WA 99217
First date of business: January 1996
Phone: (509)489-3684
Fax Number: (509)489-3686
Email Address: drbco@msn.com
Estimated Gross Income: $100,001 and above
Products sold and Services
provided: General Contractor
Business activities in Washington Services
State:
Hire Employees
Hiring: Adults
Do you have employees working
at more than one location in
Washington State? Yes
Unemployment Insurance: All locations combined
Workers' Compensation: All locations combined
Optional Insurance
Trade Name(s)
Previously registered name(s): THE DRB COMPANY
https://fortress.wa.gov/dol/m1s/Main.aspx 1/31/2007
• Internet Master Business Application Page 3 of 3
City Licenses
City of Spokane Valley:
First date of business in the city of 01/01/2007
Spokane Valley:
Have you ever held a business No
license in this city?
Previous city license number(if
known)
Are you applying as a nonprofit No
organization?
Are you a general or specialty Yes
contractor?
Provide the contractor registration DRBCO*'011QD
number(if known)
Do you provide utility service? No
Fee Review
Processing Fee: $15.00
Trade Name Registrations (0 x $0.00
$5.00):
City of Spokane Valley License: $13.00
Amount Charged to Credit Card: $28.00
Prepared by: Danny R. Bain
Phone: (509)489-3684
By checking this box, I declare
under penalty of perjury under the
laws of the State of Washington
that I am the applicant or
authorized representative of the
firm making this application and
that the information provided in
this application, including any
additional information provided
separately, is true, correct and
complete. Yes
Your application has been completed and submitted. We will review your application within the next 24
business hours. Your license document will be mailed after all licenses are approved.
Please Print this page for your records.
Continue
https://fortress.wa.gov/dol/mis/Main.aspx 1/31/2007