1995, 06-16 Permit App: 95004327 Demolition Residence•APPLICATION INFORMATIO• 5 (-15
'What is the JOB SITE address?
2-3n F 4 51- 111 s. ci
Legal description as it appears on the property deed
ASSESSOR'S tax parcel number?
OWNER or OCCUPANT
Phone
Mailing address
City, state
Zip
Who should we contact regarding this project?
Phone
What work is being done under this permit?
C WId ` \' \ o
6
kC) u.s•
B
Contract
Building height
`Ymensions
# of stories
TOTAL SQUARE FOOTAGE
WA State Contractor licensePSIA OU
#
Mailing address
A
Archkect/ ngineer
What is .he heat source?
Main floor area
and floor area
Unfinished basement area
-Finished basement area
Garage area
Size of decks, etc.
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
S�nnmming 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.
0
N