1995, 07-24 Permit App: 95005547 ReroofAPPLICATION INFORMATION
What is the JOB SITE address? - ,
ASSESSORS tax parcel number?
Legal description as it appears on the property deed
OWNERor
OCCUPANT
elf/i'/4r' /I C/f Y'
Mailin ddresi
Phone
9z7,306s'
City, state /Zip
WJ//Y rdi,�/J /�%�li D f ��� P /(/,� / p / 20 6
oo we contact regarding
g thisproject?
/r/feOav /.0a>r leacT O'1 ( /6,
What work is/being done under this permit?
Contractor
WA State Contractor license #
Mailing address
Building height
i6iimensions
# of stories
TOTAL SQUARE FOOTAGE
Main floor area
—2nd floor area
Unfinished basement area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
What is the cost of your project? S
LSO
Cs -70 0 0 —
Manufadtu
red Home
Sig
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 Tank
s
Swimming Pool
(Circle one) Above -ground
Under
Contents of tank(s)
rou
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.
m
0