1995, 03-30 Permit App: 95001881 ReroofAPPLICATION INFORMATION
What is the JOB SITE address?
ASSESSOR'S tax parcel number?
a)
N
Legal description as it appears on the property deed
OWNER or OCCUPANT
v
f;;4 ciL
Mailing address
?z ' F / (fig.
-5)40 it a IA/ 4— _
City, state
Phone
Zip
c.
Who should we contact regarding this project?
Phone
S
2
What work is being done under this permit?
r -z r 0 0.1c
Lone
Inspector district
Property size
Hight of way width
Water district
Building
Building height
Connttr�}}ctor
✓'/
Dimensions
,-GC
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
'i 4 0 TO 7 713L
Mailing address
Main floor area
7s'4 //t4
2nd floor area
4r.4-$ t
Unfinished basement area
Finished basement area
Architect/Engineer
/ i�o�+-�—�' 7/0( -()What is at source?
Garage area
Size of decks, etc.
ar
N
D
a
d
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 #
We 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 Pool
(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.