1994, 06-15 Permit App: 94005517 ReroofII -
APPLICATION WORKSHEET
General Information
Job a—li dress
-j -Parcel number
-City
S1Pol�a�--
Sale
YQa /C
Site Information
Legal Description
Property sae
Water District
Number*
Uwwefinp BwWmgs
Hoadwidlb
'Lone'.
Project Information
Building Information
New IAdddion I Remodel I Lbange of use
SQ
Main Boor
Uncovered /covered deck
Second floor
Dwelling units
Occupant load
Budding height
Unfinished basement
Slorsra
tailtal Matenal
Budding dimensions
'Iota) square loolage
Hegl parting
Waches p parking
Spnnkkr system
I
Phone
I.number
at mga�ili ress
us re footage breakdown
Main Boor
Uncovered /covered deck
Second floor
Other
Imished basement
Phone
k9f 7 C
Unfinished basement
Garage
30
Contractor Information
Italia, and insulation information R-valrtea
m/cnr5
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numbing contactor
t
Phone
/?€n
License nr,W�nber �7
S I f%e?�ry/t O� /
Phone
k9f 7 C
License number
'Fiarbng address
-0'y.stale. sip
/ ni
-faa1111Q ra a d 76
/or/
30
1 Ovid
t�
ttYsi le, l\WThr ? Z 6 6
Heating contractor
_
YmaCe a
Ctaey
Phone
I.number
Buddy; c t ctor
/Told e_
m/cnr5
numbing contactor
t
Phone
/?€n
License nr,W�nber �7
S I f%e?�ry/t O� /
Phone
k9f 7 C
License number
'Fiarbng address
-0'y.stale. sip
/ ni
-faa1111Q ra a d 76
/or/
30
1 Ovid
t�
ttYsi le, l\WThr ? Z 6 6
Heating contractor
_
Phone
Other ccns/lumber
lceme num &r
L.cease
Phone
I.number
at mga�ili ress
Mailing eddies.
City. stair. ills
-City. sate. zip
PItOJ1;C1' CONI'ACF
PHONE
Spokane County Division of Buildings
102E West Broadway Ave * Spokane. Wa 99260 a (509) 456-3675
REGISTERED AS PROVIDED BY LAW AS A
REGISTRATION NUMBER''t
CCul
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SPOKdP1: R
112006 L.
SPO'K>,Nt
SPOKA R (i 77A1..
rFFt'CTIys UA 7r:
SIGNATURE
ISSUED BY i PARTM. OF LABOR AND INDUSTRIES
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