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2013, 07-19 Permit App: BLD-2013-1425 Tear Off, Reroof __ RECEIVED 13(,fg , e),( , pfze Community Development Department CITY OF L 1 iftilyAt Center (Staff Use Only) 1f703 East Sprag e Avenue,Suite B-3 I I SpokaneaIle W, 99206 PERMIT NUMBER: -,, . . , - .Hey 8tt M, 6 I - : .:.-•• 7 PERMIT FEE: 11"i 4000 A oermitcenterC�saokanevallev.orq REROOF CONSTRUCTION PERMIT APPLICATION COMMERCIAL % RESIDENTIAL SITE ADDRESS: 12123 E. 25TH SPOKANE WA 99206 ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: BUILDING OWNER NAME: DAN AND DORIE HILL NAME: ADDRESS: CITY: SPOKANE STATE: WA ziP:99202 PHONE: 509-838-8633 FAX: 509-747-8990 CELL: CONTACT NAME: SPOKANE ROOFING COMPANY PHONE: 509-838-8633 FAx: 509-747-8990 CELL: CONTRACTOR NAME: SPOKANE ROOFING COMPANY MAILING ADDRESS: 130 E SPRAGUE CITY: SPOKANE STATE: WA zip: 99202 PHONE: 509-838-8633 FAX: 509-747-8990 CELL: CONTRACTOR LICENSE No.: SPOKARC960PA EXPIRES: CITY BUSINESS LICENSE NO.:L0443938 DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: TEAR OFF AND RE ROOF TEAR OFF AND RE ROOF © Tear Off ❑ Overlay TOTAL COST OF PROJECT: $ 10,125.00 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. Signature Date: Method of payment: 0 Cash ❑■ Check ❑ Visa 0 Mastercard Bankcard #: EXP: 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