1995, 07-31 Permit App: 95005783 Reroof0
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APPLICATION INFORMATION
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What is the JOB SITE address? ASSESSOR'S tax parcel number?
7 5t S. 6416_ a/!c1 td4. 99a) 6, ,-.507,7 i . ii 7a
Legal description as it appears on the pro rty deed
OWNER or OCCUPANT Phone
• -ondo- 4. S -1-e4794.1611 56? - 9? -/d68
Mailing address City, state Zip
%y S. /6/at-Q.4dec-n-2 p C(/�. 99/6
Who should we contact regar- g this project? Phone
nw S 1.Q--6) 'I( 9a?-(66Kw
6a5-6EFs
What work is being done under this permit?
Lone
Inspector chstrict
Property size
Hight of way width
Water distnct
Building
Building height
#of stories
Qontractor
LSimensions
TOTAL SQUARE FOO PAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd Floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
a°
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 Aiarm Fireworks display
_
VALUE
Contractor
Contractor
A State Contractor license #
A State Contractor license #
Mailing address
II 1
Mailing address
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
COMPLETE ALL APPLICABLE INFORMATION
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