1995, 06-15 Permit App: 95004318 Reroofm
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APPLICATION. INFORMATION R6- LI�j
'What is the JOB SITE address?
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Legal description as it appears on the property deed'
ASSESSOR'S tax parcel number?
OWNER or OCCUPANT
Mailing address
City, state
Phone
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Who should we contact regarding this project?
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What work is being done and r this permit?
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Dontractor
WA State Contractor license #
OP •
Mailing address
(Q n 7 S.
Architect/Engineer
Building height
Dimensions
Main floor area
and floor area
barage area
# of stories
TOTAL SQUARE FOOTAGE
Unfinished basement area
Finished basement area
Size of decks, etc.
What is the heat source?
What is the cost of your pfpject (--
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 if
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Fire Safety;
Previous address
Fire Sprinkler _
Paint booth Fire Alarm
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Feet Storage Tanks
Swimming>Pool
(Circle one) Above -ground Under
Contents of tank(s)
rou
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.
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