1995, 06-09 Permit App: 95004122 Reroof'What is the JOB SITE address?
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APPLICATION INFORMATION
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ASSESSORS tax parcel number?
Legal' description as it appears on the property deed
OWNER or OCCUPANT
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Mailing address
Phone
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Zip
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Who should we conte regarding this project?
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/ Phone
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What work is being done under this permit?
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Contractor
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Finished basement area
Archdect/Engineer
Garage area
Size of decks, etc.
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
Paint booth Fire Alarm
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address.
Fuel Storage Tanks;
Swimming,Pool
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the banjo of disability in the admission to, or treatment or employment in, its programs or activities.
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