1996, 02-29 Permit App: 96000998 ReroofN
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APPLICATION INFORMATION
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What is the JOB SITE address? ASSESSOR'S tax parcel number?
35"j 1V Az/e 2/,J
Legal description as it appears on the property deed
OWNER or OCCUPANT
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Mailing address
57V 1(14/.!
Phone
-71k k
Who should we contact regarding this project?((_
City, state
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Zip
Phone
What work is being done under this permit?
Water district
Contractor
WA State Contractor license #
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Mailing address
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Building height
Dimensions
Main floor area
-2nd floor area
# of stories
TOTAL SQUARE FOOTAGE
Unfinished basement area
Finished basement area
ArchitecVEngineer
Garage area
Size of decks, etc.
What is the heat source/
What is the cost of your project/
Manufactured Home
Sign
Width:
Length:
What is the square footage of
the sign face/
How high is the sign7
Year:
Make:
Installer
Contractor
Wa State Contractor license #
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
IFuei Storage Tanks
Swimming` Poon
(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.
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