1995, 06-12 Permit App: 95004199 Remodeln
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APPLICATION INFORMATION
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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
Who should we contact regarding this project? Phone
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What work is being done under this permit? n
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Inspector distnct
Property size
fight of way width
Water district
Building ,;
Building height
#of stories
Contractor,,bb��
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Dimensions
TOTAL SQUARE FOOTAGE
WA State or license #
Main floor area
Unfinished basement area
Mailing address
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2nd floor area
Finished basement area
Architect/Engineer
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Garage area
Size of decks, etc.
What is the heat source?
What i the cost of your_project?
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Manufactured :Home
Sign.
Width:
Length:
What ie 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- ; , , .
FireSafet
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
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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