1996, 04-19 Permit App: 96002596 Reroof APPLICATION INFORMATION 1 — S• G
"What is the JOB SITE address? / ASSESSOR'S tax parcel number?
Legal description as it appears on the prooperty deed
OWNER OCCUPANT f Phone
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Mailing address City,state Zip
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Who should we contact regardingiis project? Phone
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What work is being done under this permit?
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G9ne Inspector district Property size Right of way width
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Water district...':'?`'
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Building _ height Building g #of stories
Dimensions TOT
FOOTAGE
ALSQUARE
Contractor
/7/ /1COC::-/A/C- c& ,
WA State Contractor license# Main floor area Unfinished basement area
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Mailing address 2nd floor area Finished basement area
Architect/Engineer barage area Size of decks,etc.
What is the heat source? What is of your project?
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Manufactured Honrt Sin
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
Fuel Storage Tank$ > Swimming Pool
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(sl Si a/gallons
Public/semi-private
Contractor Contractor
a 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.