1995, 07-14 Permit App: 95005234 Re-Roof ` 5 APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
`l l/ 5 . L- 77o gr.) PoP79,41)E L!o-
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
4Ra7) CfLMILE/J frocI.�gS a,25/-503y
Mailing address City,state Zip
60/ e e TA ,Q S P k.4/1-/r w141 q92 / (c
Who should we contact regarding this project? Phone
`-_-51F--A.KA �o�S�� c .PP/4 J - /A/c y 3 s s c y
What work is being done under this permit?
cRocs-P
Lone Inspector district Property size Right of way width
a) a)
to (1
Water distnct'<
a
a a)
d
0
Building Building height #of stories
Contractor //vc_ Dimensions TOTAL SQUARE FOOTAGE
`DTCRR-A e0A(-57AiAcT«sA( of 5PokRA/6.
WA State Contractor license# Main floor area Unfinished basement area
/23KL_
Mailing address orci 20, 2nd floor area Finished basement area
(o/� i1 �u(tA SPC-RA-f(( WA
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your projectZ/
0
_ -
Manufactured Home Sign
Width: Length: What is the square footage of How high is the sign?
the sign face?
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.