1996, 05-06 Permit App: 96003115 Tear Off, ReroofAPPLICATION INF MATION
What is the JOB SITE address?
704/ //. (�n/.)
Legal description as it appears on the property deed
., ASSESSOR'S tax parcel number? ' CLI
OWNER or OCCUPANT
/2es. j✓J
Mailing address
Phone
City, state
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Zip
Who should we contact regarding this project?
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Phone
What work is being done under this permit?
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Contractor
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
X325 N . i{`flov-\•Y:�E__
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
Whet is the heat source?
What is the cost of your project?
Manufactured Horne
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 Sprinlder _
Tent
Paint booth _ Fire Alarm _ Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Fust -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.
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