1996, 07-09 Permit App: 96005303 ReroofWhat is the JOB SITE address?
APPLICATIOFIINFORMATION
/ 3V/
Legal description as it appears on the property deed
ASSESSOR'S tax parcel number?
OWNER or OCCUPANT
4-4_ 51
Mailing address
/ 3 F Zr'>
Phone
l>6 -77.2
Who should we contact regarding this projec
City, state
Zip
What work is ming done under this permit?
Gone ; .. y;::; Insoector distract
Phone
Building
Contractor
WA State Contractor license.#'
Mailing address
Building height
Dimensions
Main floor area
# of stories
TOTAL SQUARE FOOTAGE
Unfinished basement area
Architect/Engineer
2nd floor area
Garage area
Finished basement area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
3-2
Manufactured Hame
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
Contractor
Fire Sprinkler _
Tent
Paint booth _ Fire Alarm _ Fireworks display _
ALUE
Contractor
WA State Contractor license #
Mailing address
A State Contractor license #
Mailing address
Fuel Storage Tanks:'::
Swimming Pool
(Circle one) Above -ground
Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Contractor
Contractor
Public/semi-private
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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