1995, 11-27 Permit App: 95009878 ReroofCj-
APPLICATION INFORMATION 15
'What is the JOB SITE address? ASSESSORS tax parcel number?
Legal description as it appears on the property deed
OWNER or OCCUPANT
Phone
Mailing address �7
/,(7 / C...� `? VI ✓ ` ,P,
Who show's we contact regarding this project?
City, state
Phone
Zip
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
.2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Manufactured Home
Sign
Width:
Length:
What is the square footage of
the sign facet
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
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0.
d
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.