1996, 07-25 Permit App: 96005915, 96005916 Reroof((r 'Wka
APPLICATION INFORMATION
_5cIC.
\What is the JOB SITE address'?
2o7-ao -2/1- I3
Legal description is it appeals on the property deed
ASSESSOR'S tax parcel number?
s,s-Dba, iso7
T -7 g--(
OWNER or OCCUPANT
g fLec.,-)
Mailing address /J
-2D-/1 - ti.Qac-s �.d
9C>e
City, state
Phone
3,-/-10 3 c It c -'` z
Zip
Who should we contact regarding this project?
/ l p�6- D b 6
What w�irk is being done under this permit?
Phone 756 l 510
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B
WA State Contractor !cense #`
,
(2 L)6 F / e f 17/0/
Mai ing address
g / r -4L, sty ��zr
Architect/Engineer
Building height
Dimensions
Main floor area
# of stories
TOTAL SQUARE FOOTAGE
Unfinished basement area
2nd floor area
Finished basement area
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
ace, ir
Manufactu
red Hom
e
Sign':
Width:
Year:
Installer
Length:
Make:
What is the square footage of
the sign fac
C
Contract r
How high is the sign?
co)
a+
Ct.
m
CI
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Flre Safety;:
Previous address
Fire Sprinlder
Paint booth Fire Alarm
Tent
Fireworks display
ALUE
Contractor
Contractor
WA State Contractor license #
A State Contractor license #
Mailing address
Mailing address
Fuel Storage;; Tanks
Swimming Poop
(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.