1995, 05-01 Permit App: 95002813 Tear Off, ReroofAPPLICATION Il ?FORMATION
'What is the JOB SITE address?
ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
OWNER or OCCUPANT
Mailing address i t
/s----10 $,
1
Who should we contact regarding this project?
et,
What work is being done under this permit?
Phone
2.G _ss--e)c{
City, stateZip
5pai_ u)6
2L( d6, 7
Contractor.A ,A a_tx9C, v
WA State raptor license # j.
Wt D66 OS—
Mailing ad res 100 7 L
Architect/Engineer
Building height
# of stories
Dimensions
TOTAL SQUARE FOOTAGE
Main floor area
2nd floor area
ft. s
Unfinished basement area
Finished basement area
Garage area
Size of decks, etc.
co
h
ar
O.
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 sign7
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 Poo!
(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 basis of disability in the admission to, or treatment or employment in, its programs or activities.