1995, 03-20 Permit App: 95001554 Repair Fire DamageAPPLICATION INFORMATION
What is the JOB SITE address?• ASSESSOR'S tax parcel number?
Leal description as it appears on the property deed , • 1
eil u` leS• 1 / Liln/ LI
R4i0 %02`/-5 20
CdICK
NER or OCCUPA T / Phone
as C C kc CR It- s,0
Mailing address City, state Zip
I ,LI 0O I /7 h K 3,) C - �/' -7 �`(7 ate 4 r� o �/
Who sh uld we contact regarding this project? Phone
l
What work is being done under this permit?
ePlc c -c 1 kt ,R tiINit�o0 C,)IkeKln/ SAee/ �dck, 1
�1 7/ pi
Lone .
Inspector district
roperty size
Rig t of way wi h
Water district
Building
Building height
# of stories
Contractor
HO *1-t, OM keg
Dimensions
3 o X 6 S
TOTAL SQUARE FOOTAGE
9 rd
WA State Contractor license #
Main floor area
Unfinished basement area
4/%C)
Mailing address
22 // C'h_aR v / r -e
2nd floor area
4,0 N -C__
Finished basement area
t/ //6
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
6 d/)
What is the cost of your project?
/f 0
Manufactured Horne
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 Alarrn 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
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.