1995, 08-08 Permit App: 95006068 Repair Fire Damage S 3 22J-/- APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
Legal description a t appears on the pro.-rty deed
Shu-3-erh. 4. 1 C / 3 6 7
OWNER or OCCUPANT Phone
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Mailing address City,state Zip
Whoi.iould we contact regarding this project? Phone
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What work is being done under this permit? ,- ,
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Lone Inspector distract Property.size Hight•of way width
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y
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Water district ;: :: ;: e ;'
4'
0 a
a
Building Building height #of stories
Cgntractor Dimensions TOTAL SQUARE FOOTAGE
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01'16_D -t�cT'3� c! 6\v (cc\Ics
WA State Contractor license# Main floor area Unfinished basement area
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Mal ing address � 2nd floor area Finished basement area
H 3 + \ ) 'J / � ' t?L () ,:
Architect/Engineer ) Garage area Size of decks,etc.
What is the heat source? What is the cost of your project?
Manufactured Home n
Si9
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocation Fire Safety
Previous address Fire Sprinkler _ Tent
Paint booth_ Fire Alarm _ Fireworks display
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
Fuet Storage Tanks Swimming Poot
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license# WA State Contractor license#
Mailing address Mailing address
COMPLETE ALL APPLICABLE INFORMATION
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