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1995, 10-04 Permit App: 95008038 Reroof
a V5? APPLICK ION INFORMATION What is the JOB SITE address? ASSESSOR'S tax parcel number? ',q,e s ti e_ •e - a1 _g,,,,_/e., Legal description as it appears on t e property deed OWNER or OCCUPANT Phone Mailing address City, state Zip Who should we contact regarding this project? Phone s-fe-t)e- G2;1Ie 4/ 3----5-5-Di What work is being done under this permit? Lone Inspector distract Property size Hight of way width .. ;:. Water district Building Building height # of stories Contractor -); CY rCj C©ilsfru c ti' r -i Dimensions TOTAL SQUARE FOOTAGE WA State Contractor license # sr r ec0-5-0cc 4/ 3- Main floor area Unfinished basement area Mailing acjdress Goll /tt d\A l' U 2nd floor area Finished basement area Architect/Engineer Garage area Size of decks, etc. What is the heat source? What is the cost of yoproject? r9'`-' 9/E 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 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 Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities. m O