2010, 04-22 Permit App: 10001127 Tear Off, Reroof Community Development Department
CITY OF Permit Center (Staff Use Only)
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11703 East Sprague Avenue, Suite B-3 l
o1 a Spokane Valley, WA 99206 PERMIT NUMBER: 1
Tel: (509) 688-0036 5-
Fax:
Fax: (509) 688-0037 PERMIT FEE:
permitcenter@spokanevallev.orq
REROOF CONSTRUCTION PERMIT APPLICATION
COMMERCIAL 1 RESIDENTIAL
SITE ADDRESS:11221 E 22ND AVE
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:RICHARD AMES
NAME:RICHARD AMES
ADDRESS:11221 E 22ND AVE
CITY:SPOKANE VALLEY STATE:WA ZIP:
PHONE: FAX: CELL:
CONTACT NAME:JOE MUCKENTHALER
PHONE:208-704-3214 Fax:208-262-9455 CELL:208-704-3214
CONTRACTOR NAME:GORTON CONSTRUCTION, INC.
MAILING ADDRESS:1036 N INNOVATION WAY
CITY:POST FALLS STATE:I D ZIP:83854
PHONE:208-262-9450 FAx:208-262-9455 CELL:
CONTRACTOR LICENSE No.:602012144 EXPIRE5:12/10 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE:
RE-ROOF RESIDENTIAL HOUSE
Tear Off ❑ Overlay
TOTAL COST OF PROJECT: $3000
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.
Signature Date:4/22/10
Method of payment: ❑ Cash ® Check 0 Visa 0 Mastercard
Bankcard #: EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
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App.l.doc