1995, 10-27 Permit App: 95008967 ReroofAPPLICATION INFORMATION
What is the JOB SITE address? ASSESSORS tax parcel number?
6 D.:3 V\ , Qo..,Ls� ��
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
L
�y.,cz_\.�S b . S\ _,. CS -2- _ X35
Mailing address \ City, state \ C 1 Zip
%—i-3 Q3 \�1 . L. O�Q l� (� \� c J 'p c. ,� v� - IZb �P
Who should we contact regarding this project? Phone
-e- C\ -2-* —S 6-3
What work is being done under this permit?
Lone
Inspector distnct .... .. ....
Property size
Right 0 way width ....:::;.. .
Water district
Building
" in height
Building g
# of stones
Contractor
V‘1,..),oJa-,CL
Dimensions
TOTAL SQUARE FOOTAGE
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?
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
r
Relocation
Fire Safety
Previous address
Fire Sprinkler Tent
_ _
Paint booth _ Fire Alarm _ 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
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.