1995, 08-16 Permit App: 95006357 Reroof0.
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APPLICATION INFORMATION
9.16 5S)
What is the JOB SITE address? ASSESSOR'S tax parcel number?
9y2 S, A A:LIMF'a SAEtkirAf WA , tt 9 at 4,
Legal description as it appears on the property deed /
OWNER or OCCUPANT •t Phone .
Pautr/AtE c(l�KA 1,67/
Mailing address City, state . Zip
C)/2 .,• AMAA 'R 5P0M3011E( tJA- `9.2/G
Who should we contact regarding this project? Phone
5/E122A dolls iandTio c/ c41 Pok4s C i,VC 4/S3 33-0 Cl
What work is being done under this permit? pp
Lone
Inspector distract -
Property size
Right of way width
Water district
........ -
Building-..__ '
Building height
# of stories
Contractor
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
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Main floor area
Unfinished basement area
Mailing
Mai iaddress 4 ao 9
66/P Act Q-J;A 5/'of?AAsii"� elmI
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? ,
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Manufactured Home
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
Y
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
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
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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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