1995, 09-08 Permit App: 95007118 Safety Inspectm
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APPLICATION INFORMATION
'What is the JOB SITE address? s ASSESSOR'S tax parcel number?
/..09 3 (, 7f1a,/i
Lal description ask appears on the pr rty deed
L;deoC+U t Te? -F ,!3/3/ iv/s'‘),Rs- ' c'/4/,PS-'PX
L.57/7. a.
OWNER or OCCUPANT Phone
L-kke 9'- y fz / M a4/2 gal ss38
Mailing address t City, state Zip
/a9o.3F1.`'YIot.,K S Qvie a/V199 06,
to
ho should we contact regarding this project? Phone s 7 �} o;oZ _ 7-2 0 .0
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i Lz y --ha n vi Q2 - S 38 n r aloc , n-LOYI 44. P (e_ r
What work is being done under this permit.? /
'l a /17-47 (�1/
Zone
Inspecordistric di
rope size•Right
of way width
Water district......
8uildin
- -
Building height
# of stories
Contractor
-
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area -
Finished basement area
ArchitecUEngineer
Garage area
Size of decks, etc.
What is the heat source?
What is the coat of your project?
Manufactured Home ..
Signe ''' :. .,. .
Width:
Length:
What is the square footage of .
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
We 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
1 a
Mailing address
Fuel;Stoge Tanker
Swimming Pool
(Circle on Above -ground Underground
rze / gallons
Private
Contents o7fank(8
Size /gallons
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
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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