1995, 09-06 Permit App: 95006996 RemodelAPPLICATION INFORMATION 9S- Coc1
What is the JOB SITE address?
ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
•Ket /te`H1 3 / AD1r,�
OWNER or OCCUPANT
f‘25 /Ed-Gi! O
Phone
Yu i; W 9912-/k
Mailing address City, state
e n he -1-14 5 aA Melanie baro i
Who hould we contact regarding this project?
Zip
Phone
What work is being done under this permit?
;1115h
�ae�
contractor
Building height
Dimensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor license #
Mailing address
Main floor area
Unfinished basement area
Architect/Engineer
2nd floor area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
Manufactured Home
gn
Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Wa State Contractor license #
Contractorr,
r
)en4 f:'71-4 .11165611 0 kJ MeV
Wa State Contractor license # I
Mailing address
Mailing address
Relocation
F•
ire 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
Under
Contents of tank(s)
roun
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
CO
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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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