1995, 10-18 Permit App: 95008599 ReroofAPPLICATION INFORMATION (715- E15`511
What is the JOB SITE address?
Legal description a it appears on the property deed
y t e
ASSESSOR'S tax parcel number? �c
q D5o
OWNER or OCCUPANT
Mai g address
/'Who should we
contact r arding this
Phone
City, state
A) Alf 1-g_/
Zip
What work is being done under this permit?
CILe- "OO k S I E NLC
Sone Inspector district
Phone
l;,7 —
Contractor
Building height
# of stories
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Main floor area
Unfinished basement area
Mailing address
2nd floor area
Architect/Engineer
Garage area
Finished basement 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 sign?
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
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.