1995, 09-05 Permit App: 95006958 ReroofAPPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
/D� /A/ /21-6(//-e-<- �' r ��
t
Legal description as it appears on the property deed
OWNER or OCCUPANT
(095,K
Ve. k'adck.1-e___. '°a r jc L-13
Mailing address
13,2V /1/1 / u f XIJ' •
Who should we contact regarding this project?
W at work is being done under this permit?
n7/4,,
City, state
/4+V-44
Phone
(/o7C- 5 0-2
Phone
Zip
99(937
rd q
might of way width ar
Contractor
WA State Contractor license #
Mailing address
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
Main floor area
Unfinished basement area
Architect/Engineer
2nd floor area
Finished basement area
Garage area
Size of decks, etc.
Whet is the heat source?
What is the cost of your project?
A200
0
MailtifatititediiHdret6w.
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
ReI.ocation
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
iii a
an
(Circle one) Above -ground
Underground
Contents of tank(s)
Contractor
Size / gallons
Swimming Pooi
Size / gallons
1
Private
Public/semi-private
Contractor
N
a
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