1996, 06-28 Permit App: 96005001 Re-RoofAPPLICATION INFORMATION
What is the JOB SITE address?
Legal description as K appears on the property d
7
ASSESSOR'S tax parcel number?
OWNER or OCCUPANT
ate
Mailing address
Z3 } 4•7;
Phone
Zip
Who should we contact regarding this,projec
What work is being done under this permit?
Phone
,)k _.
Contractor
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
/1(C# ') c
Mailing address
Main floor area
/g/IJ 2-L
Architect/Engineer
2nd floor area
Unfinished basement area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source/
What is the cost of ymaproject/
y.7 3J
Manufactured Home
Sign
...............
Width:
Length:
What is the square footage of
the sign face7
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 Sprinlder _
Paint booth Fire Alarm
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license*
WA State Contractor license #
0)
N
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
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.