1995, 04-17 Permit App: 95002405 ReroofAPPLICATION' INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
,3. 400 ,
c)undgv r)?
Legal description as it appears on the property deed
OWNER or OCCUPANT
eek 1/Q
GC—V
Mailing address
Phone
City, state
Zip
Who should contact regarding thA project?
e til 11 WO CIA
Phone
What work is being done under this permit?
2
0
v?
Inspector district
Building height
# of stories
Contractor
--eaCh Q-
WA
State Contractor license #
D
AEA -1477)7-7 AA:
Mailing a r
Architect/EngN g er
fDX ,1c
What is the heat source?
Dimensions
6 /-
TOTAL SQUARE FOOTAGE
Main floor area
Unfinished basement area
2nd floor area
Garage area
What is the cost of your project?
Finished basement area
Size of decks, etc.
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
Swimming Pool
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
A 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.
a)
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