1995, 08-17 Permit App: 95006380 ReroofAPPLICATION INFORMATION
What is the JOB SITE address'?
i 5 O�
Legal description as it appears on the property deed
0,-teV\VI
c7 3 c6
ASSESSOR'S tax parcel number?
ys eex,13/)3
OWNER or OCCUPANT
wek
Phone
Mailing address
/5 7 I 0---Ievj,
Who should we contact regarding this project?
LA Q
What work is being done under this permit?
`�
2 e o o c 4_ (a 1 u M t w -t`1 a S c t (1..,
_ City, state
<>1)0 c l a IA -P..
LJ
Zip
Phone
Li 46 0
Contractor
IS1
e i'.J t e v 5
WA State Contractor license #
1_x\1:- A t1T.!
ti
11 c
Building height
'iYmensions
# of stories
TOTAL SQUARE FOOTAGE
Main floor area
Unfinished basement area
Mailing address c Z l 8'po a r s R
6, v, e_ t -c-.) A
Architect7En sneer
'2nd floor area
barage area
Finished basement area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Manufactu
red Horn
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
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.
h
a