2011, 06-30 Permit App: 11001942 Tear Off Reroof Community Development Department
Permit Center (Staff Use Only)
Cnl of 11703 East Sprague Avenue,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER: /l —f 9�Z
Tel: (509)688-0036 zz �7c
'iy Fax: (509)688-0037 PERMIT FEE: 7J'
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REROOF CONSTRUCTION PERMIT APPLICATION
❑ COMMERCIAL CI RESIDENTIAL
SITE ADDRESS: 6018 East 11th Ave, Spokane Valley, WA 99212
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: James A. Sanders
NAME:James A. Sanders
ADDRESS:6018 East 11th Ave
Cnv: Spokane Valley STATE:WA zip99212
PHONE: 509413-9555 FAX: CELL:
CONTACT NAME: James A. Sanders
PHONE: 509-413-9555 Fax: CELL:
CONTRACTOR NAME: James A. Sanders
MAILING ADDRESS:
CITY: Spokane Valley STATE: WA ZIP: 99212
PHONE: 509413-9555 413-9555 FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
Replacing approximately 700 square feet of roofing on the West side of the house only. Strip off old roofing and replace with new roofing.Will also replace existing roof vents with new roof vents.
Replacing approximately 700 square feet of roofing on the West side of the house only. Strip off old roofing and replace with new roofing.Will also replace existing roof vents with new roof vents.
• Tear Off El Overlay
TOTAL COST OF PROTECT: $ $1,100.00
DISCLAIMER
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 required to be submitted and subsequently approved before this application can be processed.
Si nature � Date: (Y3d/
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Method of payment: 0 Cash 0 Check 0 Visa 0 Mastercard
Bankcard #: EXP: VIN#:
Authorized Signature:
Effective October 28,2007 Page 1 of 1
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10.28.07.doc