1995, 08-29 Permit App: 95006774 Reroof6 I -
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APPLICATION INFORMATION ?-4
hat is the JOB SITE address?
ASSESSORS tax parcel number?
e.iciLviA1‘ AAIE WA, 19o37
al description as it appears on the property deed
D-t3B t7
OWNER or OCCUPANT
Xcvki
ailing address City, state
Phone
2.
IS a_
CALytA( 'SF).14414/E, kipt °o -3'Y
ho should we contact regarding this project? Phone
'5.4f5kRA eaAi 5rgl,f eli/PA/ cs-e spok4Afr i(83 53-0
Zip
What work is being done under this permit?
..E.Roo-P 4 I -64R -04
one:
119
a>
• '
Building height
# of stories
Contractor
5/EgaR eoivserizutlicio d -P 5f6RAttlE bvt
WA State Contractor license #
./242C S 5-0/q Sr—
Dimensions
TOTAL SQUARE FOOTAGE
Main floor area
Unfinished basement area
Mailing address
Alt tpoli?
Architect/Engineer
2nd floor area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?.
pi 66
34/ehi •
Manufactured Ho e
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 Sa
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
VALUE
Contracto
Contracto
rMailing address
1
A State Contractor Iicense
A State Contractor license #
(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