1995, 08-18 Permit App: 94002558 ResidenceAPPLICATION INFORMATION
What is the JOB SITE address? ) ASSESSOR'S tax parcel number?
E 6- 0 IS b, I(4 LJ 1 1/v
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone � � � �
SKi 0 Li \l
Mailing address , I City, state % Zip
i / 9' uCr'1/ l7 __ C 1 ��
Who should we contact regarding this project? Phone
SIA 1(V-‘-"R
What work is being done under this permit?
one
nspec or . is nc
'rope y size
' ig o way wi.
Water district
Building
Building height
# of stories
Contractor
Dimensions f
TOTAL SQUARE FOOTAGE
WA State Contractor lice se # \ /
Main floor area
SS
l U Scg'
Unfinished basement area
/-- 9 7
Mailing address
2nd floor area
Finished basement area
Architect/Engineer
Garage area u
�.i u f
Size of decks, etc.
- 2.
What is the heat source?
What is the cost of your project?
Manufactured Home
Sign
Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Fire Safety
Previous address
Fire Sprinkler Tent
_
Paint booth Fire Alarm Fireworks display
_ _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
I
Mailing address
1 I
Fuel Storage Tanks
Swimming Pool
(Circle one) Above - ground Underground
Size / gallons
Private
Contents of tank(s) (Size / gallons
Public /semi - private
Contractor
Contractor
WA State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
fl.
sNuel oRdag ❑
MOJJe y1JON ❑
se! !Iiln punoi6Japun ❑
s6ulpllnq pasodoid 1g Bullsixa iiv ❑
seu!I A2JedoJd 19 spew, 81emmid
'sAem Jo 1413u 'spew 10 Jaluao wOJ} saouels!Q ❑
sluawsea 7g sAemeApp 'sAempeOJ II`d ❑
:DNIM0110d 3Hl 34f110N1
3r 57)
MMMM
•••
\7
Ira
i
•
1 IIIIII
111
III ii
i►`
u�ld 01!S