1996, 09-16 Permit App: 96007772 Tear Off, Reroof(a
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'767 sr/7a, APPLICATION INFORMATION
'what is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
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Mailing address City, state Zip
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Who should we contact regarding this project? Phone
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What work is being done unde his permit? —cd.zs.r o%Q e :St.s...x Cec_c� S:c.S
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Lone . .
Inspector district
Property size .. ., .
Hight of way width
Water district
Building
Bu' mg heig t
# of stories
Contractor l
CO)�''�nJ q
/\/--C,J
ensions
TOTAL SQUARE FOOTAGE
WA State Co ctor license #
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Main floor area
Unfinished basement area
Mauling address •
/ (FG• �i/t
d floor area
Finished basement area
Architect/Enginee
Gar ge area
Size of decks, etc.
What is the heat source?
at is the cost of your project? `y 0-0
Med-, r,'„ f}prox;.�-,4c "root�-
Manufactured Home
Sign
Width:
Length'
Whet 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
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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